RESUMO
OBJECTIVE: To collect the clinical data of non-cardiac inpatients with coronary heart disease risk factors and analyze the pathogenic factors and prognosis features of these inpatients with acute myocardial infarction. METHODS: Retrospective analyses were performed for 650 cases of consecutive non-cardiac inpatients with coronary heart disease risk factors at Tianjin Union Medical Center between January 2009 and January 2012.They were divided into non myocardial infarction (UnAMI, n = 551) and myocardial infarction groups (AMI, n = 99). Firstly the method of single factor analysis was employed to screen some significant influencing factors of acute myocardial infarction.Secondly multivariate Logistic regression analysis was performed to analyze the risk factors associated with the onset of AMI. Also the cardiovascular death event rates during hospitalization were compared between two groups. Cox regression analysis was performed to analyze independent risk factors for cardiovascular death of two group during hospitalization. RESULTS: (1) The significant influencing factors of AMI included total cholesterol (TC), low-density lipoprotein (LDL), advanced age, discontinuation of antiplatelet drug, recent episodes of angina above II grade, arrhythmia, 5 years of PCI or CABG history, blood glucose control or not, cardiac dysfunction (NYHA II-IV), dehydration, severe inflammatory response, infection, peroperative period, emergency operation and without cardiological consultation. (2) Multivariate Logistic regression analysis showed that LDL (OR (odds ratio): 2.047, 95% CI (confidence interval): 1.066-3.930, P = 0.031), discontinuation of antiplatelet drug therapy (OR:15.213, 95% CI: 5.746-40.281, P = 0.000), recent episodes of angina above II grade (OR: 1.990, 95%CI: 1.155-3.430, P = 0.013), glucose non-control (OR: 2.991, 95% CI:1.485-6.026, P = 0.002), advanced age (OR: 2.499, 95% CI: 1.299-4.808, P = 0.006), severe inflammation (OR:4.425, 95% CI: 2.984-6.561, P = 0.000), infection (OR:2.405, 95% CI: 1.058-5.464, P = 0.036), emergency operation (OR:4.365, 95% CI: 1.580-12.060, P = 0.004) were all AMI-related occurring factors. And cardiologic consultation (OR: 0.011, 95% CI:0.003-0.040, P = 0.000) was a favorable factors to reduce AMI; (3) AMI group during hospitalization for cardiovascular death event rate was higher than the UnAMI group; (4) Advanced age (ß = 0.776, OR = 0.460, 95% CI: 0.217-0.974, P = 0.042) and without consultation of cardiology department (ß = 1.366, OR = 3.918, 95% CI: 1.549-9.912, P = 0.004) were cardiovascular death independent risk factors. CONCLUSION: (1) Non cardiac inpatients during hospitalization LDL, discontinuation antiplatelet drug therapy, recent episodes of angina above II grade, blood sugar non-control, advanced age, severe inflammatory response, infection and without cardiologic consultations were significant risk factors for AMI. (2) The treatment of Department of Cardiology specialist for non cardiac inpatients with coronary heart disease risk factors to improve the prognosis of them.
