ObjectiveTo evaluate the prognosis factors for early death (within 60 days) of acute myocardial infarction (AMI) patients for early identification and prevention of the disease.
MethodsWe analyzed the information of AML patients who were admitted to the emergency department between May 2009 and July 2010, and analyzed their clinical data, such as gender, age, prehospital time, myocardial enzyme, electrocardiogram, complications, whether the patients had thrombolysis therapy, time of thrombolysis, end point observation and time of death, ect. Cox multivariate survival analysis was performed with the use of SPSS 18.0 software.
ResultsSeventy-one cases were collected with one of them excluded for fragmented data. After analysing, we found that patients' age and isoenzymes of creatine kinase (CK-MB) level were prognosis factors for early death. Further analysis showed that the relative risk (RR) of age was 1.166 (P=0.023), and the RR of CK-MB was 1.001 (P=0.004).
ConclusionPatients' age has predictive value for early death of AML. More attention should be paid to AML patients with advanced age. Detecting myocardial enzymes levels, especially the CK-MB level, is significant for predicting early death. Other indicators need to be further explored due to the possible limitation of our study.
Objective To investigate the correlation between glycosylated hemoglobin A1c (HbA1c) and severity of coronary artery lesions in young men with acute myocardial infarction (AMI). Methods Total 278 young men with AMI less than 45 years old were retrospectively studied, and all of them were admitted to hospital from January 2009 to December 2011, and had undergone coronary angiography. According to the results of coronary angiography, the patients were divided into three groups based on the number of artery lesions: the single group (156 cases), the double group (64 cases) and the triple group (58 cases). The relationship between the severity of coronary artery lesions and the following factors were observed: HbA1c, systolic blood pressure (SBP), diastolic blood pressure (DBP), hemoglobin (Hb), serum uric acid (UA), total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), body mass index (BMI), smoking history, drinking history and family history of early coronary artery disease. Results a) HbA1c levels were gradually raised in all the three groups, but the single group (6.39±1.67%) was significantly lower than the double group (6.91±1.63%) and the triple group (7.41±2.12%), with significant differences (Plt;0.05); the HbA1c level of the single group was significantly lower than the triple group in both the ST-segment elevation AMI (6.42±1.68% vs. 7.17±1.86%, Plt;0.05) and the non-ST-segment AMI (5.57±0.37% vs. 8.56±2.83%, Plt;0.05); the HbA1c level of the single group was significantly lower than the triple group in patients with diabetes millitus (8.31±1.83% vs. 8.59±2.02%, Plt;0.05) and in patients without diabetes millitus (5.56±0.33% vs. 5.74±0.37%, Plt;0.05); b) There were significant differences in SBP, TC, HDL-C, LDL-C and drinking history between the single group and the other two groups (all Plt;0.05), and there were significant differences in DBP and TG between the single group and the double group (all Plt;0.05); and c) The results of logistic regression analysis showed that, LDL-C (OR=1.790), HbA1c (OR=1.287) and SBP (OR=1.042) were the independent risk factors (all Plt;0.05) for multiple lesions in coronary arteries of young men with AMI. Conclusion Glycosylated hemoglobin A1c is an independent risk factor for multiple lesions in coronary arteries of young men with AMI.
Objective
To estimate the incidence of post-myocardial infarction depression among Chinese acute myocardial infarction (AMI) patients by meta-analysis and to provide references for the management of AMI patients.
Methods
We searched databases including PubMed, The Cochrane Library (Issue 6, 2016), CNKI, CBM, WanFang Data and VIP from January 2000 to July 2016, to collect literature regarding the incidence of post-myocardial infarction depression among patients with AMI. Two reviewers independently screened literature, extracted data and evaluated the methodological quality of the included studies. Then meta-analysis was performed by using Comprehensive Meta Analysis (CMA) 2.0 software.
Results
Totally, 22 cross-sectional studies were included, involving 2 986 AMI patients, of which1 239 were post-myocardial infarction depression patients. The overall incidence of post-myocardial infarction depression among the AMI patients was 42.7% (95%CI 36.3% to 49.4%). There was no statistical differences observed when the studies were stratified by sex, regions, scales and years (allP values>0.05).
Conclusion
In China, the incidence of post-myocardial infarction depression is high and rising year by year roughly among AMI patients. The status should be paid more attention.
Objective To study the influence of autologous bone mesenchymal stem cells (BMSCs) on myocardial structure and cardiac function after being implantated into acute infarcted myocardial site. Methods Bone marrow was aspirated from the posterosuperior iliac spine of Guizhou Xiang swine. After being isolated, cultured and co cultured with 5 azacytidine, either autologous BMSCs (total cells 2×10 6, experimental group, n =12), or a comparable volume of culture medium (control group, n =12), was injected into the left anterior descending(LAD) branch of coronary artery just distal to the ligation site of the LAD. The same volume of BMSCs or culture medium was injected into several spots in the infarcted myocardium. Echocardiographic measurements were performed three or six weeks after implantation to assess the myocardial structure and cardiac function. Results Left ventricular function, including eject fraction(EF), fractional shortening and wall thickening, were higher in experimental group when compared with control group. The thickness of the ventricular wall and septum was also found increased while the left ventricular chamber size was smaller in experimental group. Conclusion Implantation of BMSCs into the infarcted myocardium is believed to attenuate the remodeling process, inhibit the extent of wall thinning and dilatation of the ventricular chamber. BMSCs implantation may also improve the contractile ability of the myocardium and cardiac function.
Objective To evaluate the diagnostic value of human heart-type fatty acid-binding protein for early detection of acute myocardial infarction (AMI). Methods Studies involving this biomarker were identified from MEDLINE, EMbase, CBM and VIP (1970 to 2006). Relevant journals (1980 to 2006) were also handsearched. The quality of the included studies was assessed using the QUADAS tool. Data extraction and analysis were conducted by software of EXCEL2003 and Metadisc. Results We included 13 studies, which were heterogeneous (P=0, I2=58.5%). Five studies (n=396) included in the group assessed the test at the first three hours after chest pain onset. These studies were homogeneous (P= 0.49, I2=0). The pooled sensitivity was 0.86 ( 95%CI 0.80 to 0.91), the pooled specificity was 0.76( 95%CI 0.80 to 0.91), and the area under the curve was 0.88 (SE=0.032 3). In the group of 0 to 6 hours after chest pain onset, 10 included studies (n=1 175) were heterogeneous (P=0, I2=69%). The pooled sensitivity was 0.86 (95%CI 0.83 to 0.89), the pooled specificity was 0.79 (95%CI 0.76 to 0.82), and the area under the curve was 0.92 (SE=0.019). In the group of 6 to 12 hours after chest pain onset, 4 included studies (n=215) were homogeneous (P=0.56, I2=0). The pooled sensitivity was 0.97 (95%CI 0.91 to 0.99), the pooled specificity was 0.52 (95%CI 0.42 to 0.61), and the area under the curve was 0.810 with (SE=0.152 2). In the group of 0 to 12 hours after chest pain, 11 included studies (n=1 352) were heterogeneous (P=0.56, I2=59%). The pooled sensitivity was 0.88 (95%CI 0.84 to 0.89), the pooled specificity was 0.75 (95%CI 0.71 to 0.78), and the areas under the curve was 0.91 (SE=0.016 4). Conclusions In this systematic review, we found that H-FABP has an acceptable diagnostic accuracy within 3 hours after the onset of symptoms, and within 12 hours after the onset of symptoms, H-FABP has a high diagnostic efficacy. So H-FABP may be a new symbol for the early diagnosis of AMI.
ObjectiveTo investigate the influencing factors of serum NT-proBNP level in elderly patients with acute myocardial infarction (AMI) after PCI, and to analyze its predictive value for the short-term prognosis of patients. MethodsA total of 98 elderly patients with AMI in Zhengzhou central hospital from May 2020 to August 2022 were selected, all of whom underwent PCI. The level of serum NT-proBNP before and after PCI was detected. The level of serum NT-probNP after PCI was ≥125 pg/mL, and the level of serum NT-probNP after PCI was normal. Univariate analysis of the general data of the elevated NT-proBNP group and the normal group, Lasso regression model was used to screen the screening variables, and Logistic regression was used to analyze the influencing factors of serum NT-proBNP level in elderly AMI patients after PCI. The prognosis recovery of patients with different NT-proBNP and the level of NT-proBNP in patients with different prognosis were compared and analyzed. ROC curve was drawn to analyze the predictive value of NT-proBNP level in patients with short-term prognosis after PCI. ResultsLogistic regression analysis showed that the time from onset to PCI, age, left ventricular ejection fraction (LVEF), stroke, number of stents implanted, no recirculation and stent diameter were the influencing factors of serum NT-proBNP level in elderly AMI patients after PCI. The incidence of adverse cardiovascular events (MACE) was 21.43% (21/98) in 98 patients followed up 6 months after surgery, and the incidence of NT-proBNP increased group was 68.00% (17/25), which was significantly higher than that of normal group (5.48% (4/73) (P<0.05). The level of NT-proBNP in the group with MACE was significantly higher than that in the group without MACE (P<0.05). ROC curve showed that AUC was 0.813 (95%CI 0.721 to0.884), sensitivity and specificity were 80.95% and 79.22%, respectively, suggesting that serum NT-proBNP level after PCI had certain predictive value for short-term prognosis of patients. ConclusionSerum NT-proBNP level in elderly AMI patients after PCI has a good ability to predict the short-term prognosis of patients. Comprehensive consideration of the number of stents inserted, the presence of stroke, the presence of reflow and age and other factors to strengthen the monitoring of NT-proBNP level is helpful to prevent and control the occurrence of MACE, so as to improve the prognosis of patients.
Abstract: Ventricular septal rupture is a rare complication of acute myocardial infarction, but it can easily lead to such complications as acute heart failure and cardiac shock with sinister prognosis. Surgical treatment is a fundamental measure to improve the prognosis, and the selection of operation time is a key factor. The basic guiding principles of operation timing are as follows. Those patients who have acute heart failure and/or cardiac shock soon after the onset of ventricular septal rupture, and can not be controlled by nonsurgery therapy and are also unable to tolerate surgery, will die soon. For them, surgery treatment cannot be implemented because they have missed the optimal operation time. For those whose perforation was so small that they can be stably controlled by nonsurgery therapy, surgery treatment can be postponed for 1 to 4 weeks. However, emergency operation should be performed in time once the condition of the patients becomes unstable. For others, no matter in what state they are, surgical treatment should be implemented immediately.
ObjectiveTo systematically review the effect of compound Danshen dripping pills combined with Western medicine on inflammatory factors and cardiac function after percutaneous coronary intervention (PCI) in patients with acute myocardial infarction.MethodsDatabases including CNKI, WanFang Data, VIP, CBM, PubMed, Web of Science, EMbase and The Cochrane Library were searched for randomized controlled trials of compound Danshen dripping pills combined with Western medicine in the treatment of acute myocardial infarction after PCI. The retrieval time was from the establishment of the databases to June 11th, 2020. Two reviewers independently screened literature, extracted data and evaluated the risk bias of included studies. RevMan 5.3 software was used for meta-analysis.ResultsA total of 16 studies were included, involving 2 069 patients. The results of the meta-analysis showed that the combination of compound Danshen dripping pills could increase the left ventricular ejection fraction (MD =?4.74, 95%CI 4.07 to 5.42, P<0.01), decrease the B-type natriuretic peptide (SMD=?3.81, 95%CI ?5.06 to ?2.57, P<0.01), the level of interleukin-6 (SMD=?3.20, 95%CI ?4.54 to ?1.86, P<0.01) and level of tumor necrosis factor-a (SMD=?4.96, 95%CI ?7.03 to ?2.89, P<0.01).ConclusionsCurrent evidence suggests that the combination of compound Danshen dropping pills has potential benefits in inhibiting inflammation and improving cardiac function after PCI. Due to the limited quality and quantity of the included studies, more high-quality studies are required to verify the above conclusions.
Objective To explore the risk factors for long-term death of patients with acute myocardial infarction (AMI) and reduced left ventricular ejection fraction (LVEF), and develop and validate a prediction model for long-term death. Methods This retrospective cohort study included 1013 patients diagnosed with AMI and reduced LVEF in West China Hospital of Sichuan University between January 2010 and June 2019. Using the RAND function of Excel software, patients were randomly divided into three groups, two of which were combined for the purpose of establishing the model, and the third group was used for validation of the model. The endpoint of the study was all-cause mortality, and the follow-up was until January 20th, 2021. Cox proportional hazard model was used to evaluate the risk factors affecting the long-term death, and then a prediction model based on those risk factors was established and validated. Results During a median follow-up of 1377 days, 296 patients died. Multivariate Cox regression analysis showed that age≥65 years [hazard ratio (HR)=1.842, 95% confidence interval (CI) (1.067, 3.179), P=0.028], Killip class≥Ⅲ[HR=1.941, 95%CI (1.188, 3.170), P=0.008], N-terminal pro-brain natriuretic peptide≥5598 pg/mL [HR=2.122, 95%CI (1.228, 3.665), P=0.007], no percutaneous coronary intervention [HR=2.181, 95%CI (1.351, 3.524), P=0.001], no use of statins [HR=2.441, 95%CI (1.338, 4.454), P=0.004], and no use of β-blockers [HR=1.671, 95%CI (1.026, 2.720), P=0.039] were independent risk factors for long-term death. The prediction model was established and patients were divided into three risk groups according to the total score, namely low-risk group (0-2), medium-risk group (4-6), and high-risk group (8-12). The results of receiver operating characteristic curve [area under curve (AUC)=0.724, 95%CI (0.680, 0.767), P<0.001], Hosmer-Lemeshow test (P=0.108), and Kaplan-Meier survival curve (P<0.001) showed that the prediction model had an efficient prediction ability, and a strong ability in discriminating different groups. The model was also shown to be valid in the validation group [AUC=0.758, 95%CI (0.703, 0.813), P<0.001]. Conclusions In patients with AMI and reduced LVEF, age≥65 years, Killip class≥Ⅲ, N-terminal pro-brain natriuretic peptide≥5598 pg/mL, no percutaneous coronary intervention, no use of statins, and no use of β-blockers are independent risk factors for long-term death. The developed risk prediction model based on these risk factors has a strong prediction ability.
ObjectiveTo systematically evaluate prediction models for in-hospital mortality risk in patients with acute myocardial infarction (AMI). MethodsA comprehensive search was conducted in PubMed, Embase, Web of Science, Cochrane Library, and CNKI databases from inception to May 30, 2025, to identify studies related to AMI in-hospital mortality prediction models. Risk of bias and applicability were assessed using the Prediction Model Risk of Bias Assessment Tool (PROBAST). Relevant data were extracted for model quality assessment. ResultsA total of 29 studies involving 75 AMI in-hospital mortality prediction models were included. Key predictive factors identified included Killip classification, neutrophil count, renal insufficiency, age, systolic blood pressure, and left ventricular ejection fraction. The area under the receiver operating characteristic curve (AUC) ranged from 0.580 to 0.998. Internal validation was reported in 21 studies, external validation in 4, and both in 4 studies. Model calibration was evaluated in 23 studies. Most models were presented as nomograms. All studies demonstrated good applicability, though 25 were rated as high risk of bias overall. ConclusionCurrent AMI in-hospital mortality prediction models show generally good predictive performance, with some variables exhibiting stable predictive effects. However, the lack of external validation and high risk of bias remain prevalent issues. Future studies should focus on prospective, multicenter, high-quality designs to enhance the practical and clinical value of these models.
