Association of chronic lung disease with treatments and outcomes patients with acute myocardial infarction
Association of chronic lung disease with treatments and outcomes patients with acute myocardial infarction
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DOI：
10.1016/j.ahj.2012.09.010
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发表时间：
2013-01-01
影响因子：
4.8
通讯作者：
Das, Sandeep R.
中科院分区：
文献类型：
--
作者：
Enriquez, Jonathan R.;de Lemos, James A.;Das, Sandeep R.
背景：虽然慢性肺部疾病（CLD）在心肌梗死（MI）患者中很常见，但对慢性肺病对MI患者管理和预后的影响知之甚少。方法使用国家心血管数据登记处的ACTION Registry- gwtg，比较急性MI患者（n = 22,624）和非CLD患者（n = 136,266）的人口统计学、临床特征、治疗、护理过程和住院不良事件。进行多变量调整以确定CLD与治疗和不良事件的独立关联。结果CLD（17.0%的非st段抬高型心肌梗死[NSTEMI]和10.1%的st段抬高型心肌梗死[STEMI]患者）与年龄较大、女性和更大的合并症负担相关。在NSTEMI患者中，与没有CLD的患者相比，有CLD的患者接受心导管插入术、经皮冠状动脉介入治疗和冠状动脉旁路移植术的可能性更小；相比之下，STEMI患者合并或不合并CLD的侵入性治疗没有差异。CLD合并NSTEMI患者的多变量校正大出血风险显著增加(13.0% vs 8.1%, ORadj = 1.27, 95% CI = 1.20 ~ 1.34， P
Background Although chronic lung disease (CLD) is common among patients with myocardial infarction (MI), little is known about the influence of CLD on patient management and outcomes following MI.Methods Using the National Cardiovascular Data Registry's ACTION Registry-GWTG, demographics, clinical characteristics, treatments, processes of care, and in-hospital adverse events after acute MI were compared between patients with (n = 22,624) and without (n = 136,266) CLD. Multivariable adjustment was performed to determine the independent association of CLD with treatments and adverse events.Results CLD (17.0% of non-ST-elevation MI [NSTEMI] and 10.1% of ST-elevation MI [STEMI] patients) was associated with older age, female sex, and a greater burden of comorbidities. Among NSTEMI patients, those with CLD were less likely to undergo cardiac catheterization, percutaneous coronary intervention, and coronary artery bypass graft compared to those without; in contrast, no differences were seen in invasive therapies for STEMI patients with or without CLD. Multivariableadjusted risk of major bleeding was significantly increased in CLD patients with NSTEMI (13.0% vs 8.1%, ORadj = 1.27, 95% CI = 1.20-1.34, P