急性冠脉综合征合并缺血性脑卒中患者的临床特点
Clinical features of acute coronary syndrome patients with prior ischemic stroke
回顾性收集2014年11月至2017年7月苏北人民医院急性冠脉综合征(ACS)患者,每月连续录入20~30例,共637例.按照是否有缺血性脑卒中分为合并组与对照组,分析危险因素、既往史、冠状动脉严重程度、用药情况及在院期间不良心脑血管事件(心源性死亡、再发心肌梗死、心力衰竭、新发脑卒中)等变量的差异.本研究中,ACS患者伴缺血性脑卒中者患病率为7.5%(48/637).合并组β受体阻滞剂使用率[50.00% (24/48)比69.78%(411/589),x2=8.02,P<0.05]及介入治疗[56.67%(17/30)比81.86%(334/408),x2=11.15,P<0.05]比例较对照组低,差异有统计学意义.而双联抗血小板、他汀及血管紧张素转换酶抑制剂或血管紧张素Ⅱ受体拮抗剂使用率组间差异无统计学意义.在院期间主要心脑血管不良事件发生率差异无统计学意义.目前我院ACS伴既往缺血性脑卒中患者治疗率与国外相关研究类似,均存在一定程度用药比率低的问题,需有更多研究关注此类患者的临床管理.
更多From November 2014 to July 2017,637 patients with acute coronary syndrome (ACS) were included in the analysis,among whom there were 48 cases with prior ischemic stroke (7.5%).The risk factors,history,severity of coronary artery disease,medication status,and incidence of adverse cardiovascular and cerebrovascular events (cardiac death,re-infarction,heart failure,stroke) were analyzed.Compare with patients without prior ischemic stroke (control group) patients with prior ischemic stroke (study group) had lower rates in administration of beta blockers [50.00%(24/28) vs.69.78%(411/589),x2=8.02,P<0.05]and interventional therapy[56.67%(17/30) vs.81.86%(334/408),x2=11.15,P<0.05].However,there were no significant differences in medication of dual antiplatelet,statins and angiotensin converting enzyme inhibitors or angiotensin receptor blocker between two groups (P>0.05);and there was no significant difference in major adverse cardiovascular events between two groups (P>0.05).In the future,more studies are needed for clinical management of this group of patients.
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