Chinese Journal of Nursing ›› 2020, Vol. 55 ›› Issue (4): 542-548.DOI: 10.3761/j.issn.0254-1769.2020.04.012

• Special Planning-Cardiovascular Nursing • Previous Articles     Next Articles

Risk factors of major adverse cardiovascular events in ST elevation myocardial infarction patients after percutaneous coronary intervention:a Meta-analysis

YAN Fanghong,LIU Huan,JIANG Wenhui()   

  • Received:2019-07-01 Online:2020-04-15 Published:2020-04-15
  • Contact: Wenhui JIANG

ST段抬高型心肌梗死患者介入术后心血管不良事件危险因素的Meta分析

燕芳红,刘欢,蒋文慧()   

  1. 730000 兰州市 兰州大学护理学院(燕芳红);西安交通大学护理学系(刘欢,蒋文慧)
  • 通讯作者: 蒋文慧
  • 作者简介:燕芳红:硕士,助教,E-mail:yanfanghong@163.com
  • 基金资助:
    国家社会科学基金项目(18BGL248)

Abstract: Objective To identify risk factors of major adverse cardiovascular events(MACEs) in ST elevation myocardial infarction(STEMI) patients after percutaneous coronary intervention(PCI). Methods Embase,Medline,Scopus,CNKI,CBM,WanFang Data,VIP,ProQuest Dissertations and Theses-A&I and Clinical Trials. gov were searched to collect studies from January 1st,2008 to December 31st,2018 on risk factors of MACEs. Study screening,data extraction,quality appraisal and meta-analysis were conducted by 2 reviewers independently. Results 35 studies,involving 43,839 patients were included. The statistically significant risk factors were female(OR=4.17),advanced age(OR=2.84),red cell distribution width≥13%(OR=2.04),abnormal renal function(OR=2.23),glucose≥11 mmol/L(OR=1.82),non-O blood type(OR=1.75),triple-vessel disease(OR=1.75),glycated hemoglobin fraction≥5.7%(OR=1.63),painless STEMI(OR=1.56),longer symptom-onset-to-balloon time(OR=1.48) and hypertension(OR=1.27). Conclusion The risk factors of MACEs in STEMI after PCI include female,advanced age,red cell distribution width≥13%,abnormal renal function,glucose≥11 mmol/L,non-O blood type,triple-vessel disease,glycated hemoglobin fraction≥5.7%,painless STEMI,longer symptom-onset-to-balloon time and hypertension.

Key words: ST Elevation Myocardial Infarction, Percutaneous Coronary Intervention, Risk Factors Analysis, Meta-Analysis

摘要: 目的 明确ST段抬高型心肌梗死(ST elevation myocardial infarction,STEMI)患者经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)术后主要心血管不良事件(major adverse cardiovascular events,MACEs)发生的危险因素。方法 计算机检索Embase、Medline、Scopus、中国知网、中国生物医学文献数据库、万方、维普等数据库,纳入2008年1月1日—12月31日关于STEMI患者PCI术后MACEs危险因素的文献。2名研究人员独立完成文献筛选、偏倚风险评价及资料提取,并进行Meta分析。结果 共纳入35篇文献,包括43 839例患者,有统计学意义的危险因素包括女性(OR=4.17)、高龄(OR=2.84)、红细胞分布宽度≥13%(OR=2.04)、肾功能异常(OR=2.23)、随机血糖≥11 mmol/L(OR=1.82)、非O型血(OR=1.75)、三支病变(OR=1.75)、糖化血红蛋白分数≥5.7%(OR=1.63)、无梗死前胸痛症状(OR=1.56)、症状出现至球囊扩张时间延长(OR=1.48)、高血压(OR=1.27)。结论 女性、高龄、红细胞分布宽度≥13%、肾功能异常、随机血糖≥11 mmol/L等是STEMI患者PCI术后MACEs的危险因素。

关键词: ST段抬高型心肌梗死, 经皮冠状动脉介入治疗, 危险因素分析, Meta分析