| Objective:By investigating and analyzing the status of patients undergoing emergency PCI in the first affiliated hospital of Shihezi university School of medicinel from January 2017 to December 2019,we can keep abreast of the population characteristics,clinical characteristics,coronary artery performance,the time node of visit,and master current treatment status.So as to provide clinical basis for diagnosis and treatment of acute coronary syndrome.Methods:From January 2017 to December 2019,1005 cases of acute chest pain were collected from the First Affiliated Hospital of Shihezi University for emergency percutaneous coronary intervention(PCI).The author collected and recorded the general situation,related risk factors and complications of the patients.Specifically,the authors grouped patients according to gender,and recorded the relevant characteristics and key treatment time nodes.The results of coronary angiography and operation mode were analyzed,and the SYNTAX score was calculated according to the condition of coronary artery disease,and the characteristics of the related population between different risk stratification groups were compared;and We recorded the analysis of related expenses,adverse events in hospital,outcome,etc.;grouped according to different types of myocardial infarction,compared the characteristics of treatment;grouped according to the certification time of chest pain center,and compared the occurrence of cardiovascular events in hospital and the death in hospital between the two groups after the Propensity Score Matched with the confounding factors.Results:1.Analysis of clinical characteristics of the patients:From 2017 to 2019,The number of patients with emergency PCI in our hospital increased,With an average growth rate of14.7%within three years and an mortality rate of 3.88%,showing a decreasing trend.872patients were diagnosed with STEMI,and 105 patients were diagnosed with NSTEMI 2.8%were diagnosed with UA.The number of males were more than females(847/15884.2%/15.8%).BMI was 25.81±3.24Kg/m~2,which was from the surrounding county more than the urban area(59.3%/40.6%).The occupational distribution was highest among workers(33.7%).Primary and secondary education(69.4%);82.4%of the patients had medical insurance,And the patients were between 19 and 89 years old.The overall average age was57.54±12.47years old,with the highest proportion of people aged 50-60 years old(33.4%).The incidence was highest in male patients aged 50-59 years,and in female patients aged 70-79 years.593(60.8%)had hypertension,288(29.4%)had diabetes,466(47.6%)had hyperlipidemia,515(52.6%)were overweight or obese,549(56.2%)had smoking,and 96(9.8%)had a family history of coronary heart disease.Overweight or obese(53.2%/40.5%),smoking(63.3%/8.2%)and multiple risk factors(32.9%/20.9%)were higher in male patients than in female patients.The proportion of female patients with diabetes was higher than that male patients(42.4%/26%).Male cerebrovascular disease(12.9%/5.7%),Chronic obstructive pulmonary diseases;The proportion of COPD was higher than women(19.0/10.1%),and the proportion of anemia in women was higher than men(9.5%/1.4%),with statistically significant differences(P<0.05).2.Analysis of the clinical characteristics of the patients.From 2017 to 2019,the emergency coronary artery characteristics of emergency PCI patients,79.1%of the patients presented right dominant coronary artery type.The 72.2%of the patients who underwent coronary stent implantation,and 14.7%was underwent coronary angiography(SCA),69 patients with PTCA and 62 patients with thrombus aspiration.There were 6 cases of temporary pacemaker installation and 22 cases of IABP.The 85.6%patients was puncture site of radial artery.According to the analysis of the types of coronary artery lesions,396patients showed thrombus in coronary artery,147 patients with calcification,39 patients with primary stent thrombosis,and 45 patients with no reflow or slow reflow after the surgery.There were 7 cases of radial artery spasm and 8 cases of spontaneous intracoronary dissection.Analysis of the degree of stenosis in the diseased vessels:9 cases of grade 1 stenosis,11 cases of grade 2,15 cases of grade 3,67 cases of grade 4,162 cases of grade 5,and 741 cases of grade 6 stenosis.The average number of stents was 1.34±0.57,and the average length of stents was 35.77±18.27mm.Most of the patients was Anterior wall myocardial infarction,single vessel disease and damage by LAD.SYNTAX score:the low-risk group was dominated(53.8%),the high-risk group had a higher proportion of women and patients with previous history of PCI,the middle-risk group had the highest average age,the proportion of patients with hypertension,the highest incidence of MACE in the hospital,and the low-risk group had the highest proportion of smoking patients.3.65.7%of patients within 6 hours total ischemia time,the incidence of nosocomial MACE events was 13.83%,the incidence of acute heart failure was 12.7%,the hospital mortality was 3.88%,nausea and the incidence of arrhythmia was 5.07%,the recurrence of 7 cases of acute myocardial infarction,707 patients were done ultrasound,252 cases of patients with EF<50%,(35.6%).The median hospital stay for all patients was 7(6,8)days,and the median hospital cost was 39,614 Yuan.Significantly less than before;Comparing the characteristics of different myocardial infarction types,the proportion of males in the STEMI group was higher than that in the NSTEMI group,and the proportion of elderly patients in the NSTEMI group was higher than that in the NSTEMI group.Compared with the treatment before and after the accreditation of chest pain center,the proportion of adverse events during hospitalization after the accreditation was reduced.Conclusion:1.The patients with emergency PCI is increasing,and the mortality in the hospital is on the decline.The death rate increases with age,which is characterized by more male patients,a high proportion of rural patients,multiple risk factor.2.Coronary artery lesions were mainly simple lesions and low lesions,with a high proportion of occlusive lesions.There were more elderly patients in the NSTEMI group and a higher proportion of multi-vessel lesions.3.The in-hospital hospitalization cost and length of stay of patients with emergency PCI were reduced,and the chest pain center verified that the occurrence of in-hospital adverse events was effectively reduced,but there was no significant change in the in-hospital mortality. |
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