| Purpose:This study retrospectively analyzed the risk factors,clinical characteristics,the incidence of major adverse cardiovascular events(MACE)and the differences in prognosis among elderly patients with acute myocardial infarction(AMI)of different genders.To provide a certain basis for the prevention and control of AMI high-risk population.Methods:A total of 506 elderly patients aged ≥60 years old who were diagnosed with AMI and underwent emergency percutaneous coronary intervention(PCI)in the Department of Cardiology,China-Japan Union Hospital of Jilin University from September 2019 to September 2020 were included,including 268 males and 238 females.On two groups of patients with cardiac troponin I(Tn I),creatine kinase isoenzyme(CK-MB)and amino terminal brain natriuretic peptide precursor(NT-pro BNP),D-dimer,myoglobin(Myo),triglycerides(TG),total cholesterol(TC),HDL-C,LDL-C,aspartate aminotransferase(AST),white blood cell count,neutrophil percentage and other biochemical indicators and age,body mass index(BMI),hypertension,type 2 diabetes,smoking,drinking,coronary heart disease family history,history of coronary artery vascular lesions,intraoperative complications and postoperative medication And the incidence of MACE events during hospitalization.Results:1.Comparison of risk factors between the two groups: the analysis showed that the age of onset in the elderly male group(68.53±6.161)was lower than that in the female group(70.18±6.713),with statistical significance(P < 0.05).The proportion of smoking in the male group was higher than that in the female group(52.24% : 36.13%),with statistical significance(P < 0.05).The drinking rate of male group was higher than that of female group(25.38% vs 5.04%),with statistical significance(P < 0.05).The proportion of hypertension in male group was higher than that in female group(46.27% vs.56.30%),with statistical significance(P <0.05).BMI of male group was higher than that of female group(24.162±0.347:23.607±0.403),with statistical significance(P < 0.05).The rate of previous CHD in male group was lower than that in female group(20.15% vs.33.61%),with statistical significance(P < 0.05).However,there was no significant difference between the two groups in risk factors such as diabetes,family history of coronary heart disease and previous history of heart failure(P > 0.05).2.Comparison of biochemical indexes between the two groups: it can be seen from the comparison of biochemical indexes between the two groups that the levels of NT-pro BNP,D-dimer,TG,TC,LDL-C and HDL-C in the elderly male group were lower than those in the female group,with statistical significance(P < 0.05).There was no significant difference in TNI,CK-MB,MYO,AST,WBC and N%between the two groups(P > 0.05).3.Comparison of coronary artery lesions between the two groups: By comparing the characteristics of coronary artery lesions between the two groups,it was found that the elderly male group was dominated by double-vessel(50%)and single-vessel(28.95%)lesions,while the elderly female group was dominated by double-vessel(33.61%)and three-vessel(40.34%)lesions,and there was a statistical difference in the number of disaffected vessels between the two groups(P < 0.05).The former descending branch was mainly in the elderly male group(52.98%),and the right crown was mainly in the elderly female group(47.90%),with statistical difference between the two groups(P < 0.05).4.Intraoperative comparison of PCI between the two groups: Through comparison of PCI between the two groups,the diameter of intraoperative stent implantation in the elderly male group was higher than that in the elderly female group(2.99±0.928):(2.78±0.371),with statistical difference(P < 0.05).There were no significant differences between the two groups in the success rate of PCI,the number of stents implanted,the length of stents implanted,postoperative blood flow,and the need for a second operation(P >0.05).5.Intraoperatie complications comparison between two groups of PCI:through the analysis can be concluded that the two groups of patients in the case of intraoperative complications(side branches occlusion,severe arrhythmia,shock,acute heart failure,no reflow/slow blood flow,severe interlayer,thrombosis),and female proportion is higher than the male group(20.59%,13.43%),with statistical difference(P < 0.05).6.By comparing the medication of the two groups,it can be found that the proportion of low molecular heparin application rate in the elderly female group was lower than that in the elderly male group,with a statistical difference(P < 0.05).There was no significant difference between the two groups in the application of anti-ventricular remodeling and lipid-lowering drugs(P > 0.05).7.Comparison of MACE events between the two groups showed that the proportion of postoperative angina in the elderly female group was higher than that in the elderly male group(18.49% vs.10.82%),with a statistical difference(P <0.05).There were no significant differences in new heart failure,cardiogenic shock,cardiac rupture,tamponade,severe and malignant arrhythmias,and mortality during hospitalization(P > 0.05).8.The incidence of MACE events in the two groups was higher in the elderly female group than in the male group,especially in the aspect of postoperative angina pectoris.Logistic regression analysis showed that it was related to female,smoking history and Intraoperative complications.Conclusions:1.In conclusion,elderly female patients with acute myocardial infarction are significantly different from male patients in terms of onset age,risk factors,biochemical indicators,pathological characteristics and therapeutic medication,and the incidence of adverse events in female patients during hospitalization is higher than that in male patients,especially in postoperative angina pectoris.Logistic regression analysis showed that the incidence was related to female,smoking history and Intraoperative complications.In clinical practice,gender differences in myocardial infarction in elderly patients should be paid attention to to improve treatment and secondary prevention strategies. |
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