RESUMO
BACKGROUND: Hyperuricemia is a risk factor for cardiovascular diseases, but the impact of hyperuricemia and sex-related disparities is not fully clear in elderly patients with acute coronary syndrome (ACS). OBJECTIVE: To investigate the association between hyperuricemia and 1-year all-cause mortality in elderly patients with ACS. METHODS: This retrospective cohort study included 711 consecutive ACS patients aged ≥75 years, hospitalized in our center between January 2013 and December 2017. Serum uric acid (sUA), in-hospital events, and 1-year follow-up were analyzed. Multivariable logistic regression models were used to explore the risk factors for in-hospital events and 1-year all-cause mortality. RESULTS: sUA levels were higher in males than in females (381.4 ± 110.1 vs. 349.3 ± 119.1 µmol/l, P < 0.001). Prevalence of hypertension (80.5% vs. 72.6%, P < 0.001). Prevalence of hypertension (80.5% vs. 72.6%, P < 0.001). Prevalence of hypertension (80.5% vs. 72.6%, P < 0.001). Prevalence of hypertension (80.5% vs. 72.6%, P < 0.001). Prevalence of hypertension (80.5% vs. 72.6%, P < 0.001). Prevalence of hypertension (80.5% vs. 72.6%, P < 0.001). Prevalence of hypertension (80.5% vs. 72.6%, P < 0.001). Prevalence of hypertension (80.5% vs. 72.6%, P < 0.001). Prevalence of hypertension (80.5% vs. 72.6%. CONCLUSIONS: Hyperuricemia is an independent risk factor for 1-year all-cause mortality in elderly female patients with ACS.
Assuntos
Síndrome Coronariana Aguda/mortalidade , Disparidades nos Níveis de Saúde , Hiperuricemia/mortalidade , Ácido Úrico/sangue , Síndrome Coronariana Aguda/sangue , Síndrome Coronariana Aguda/diagnóstico , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Biomarcadores/sangue , Causas de Morte , Comorbidade , Feminino , Humanos , Hiperuricemia/sangue , Hiperuricemia/diagnóstico , Masculino , Prevalência , Prognóstico , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Fatores Sexuais , Fatores de TempoRESUMO
Ventricular tachycardia/ventricular fibrillation (VT/VF) is a kind of malignant arrhythmia in ST-segment elevation myocardial infarction (STEMI) patients who received primary percutaneous coronary intervention (PPCI). However, there are no risk assessment tools to anticipate the occurrence of VT/VF.This study is to build a risk assessment model to predict the possibility of VT/VF onset in STEMI patients undergoing PPCI.A retrospective study was conducted to analyze the patients who underwent PPCI from January 2006 to May 2015. Subjects were divided into VT/VF group and no VT/VF group based on whether VT/VF had occurred or not. In addition, the VT/VF group was further separated into early-onset group (from the time that symptoms began to before the end of PPCI) and late-onset group (after the end of PPCI) based on the timing of when VT/VF happened. Multivariate regression analysis was carried out to distinguish the independent risk factors of VT/VF and an additional statistical method was executed to build the risk assessment model.A total of 607 patients were enrolled in this study. Of these patients, 67 cases (11%) experienced VT/VF. In addition, 91% (61) of patients experienced VT/VF within 48âh from the time that the symptoms emerged. Independent risk factors include: age, diabetes mellitus, heart rate, ST-segment maximum elevation, ST-segment total elevation, serum potassium, left ventricular ejection fraction (LVEF), culprit artery was right coronary artery, left main (LM) stenosis, Killip class > I class, and pre-procedure thrombolysis in myocardial infarction (TIMI) flow zero grade. Risk score model and risk rank model have been established to evaluate the possibility of VT/VF. Class I: ≤ 4 points; Class II: > 4 points, ≤ 5.5 points; Class III: > 5.5 points, < 6.5 points; and Class IV ≥ 6.5 points. The higher the class, the higher the risk.The incidence of VT/VF in STEMI patients undergoing PPCI is 11% and it occurs more frequently from the time that symptoms begin to before the end of PPCI, which, in most cases, occurs within 48âh of the event. Our risk assessment model could predict the possible occurrence of VT/VF.