关键词: 经皮冠状动脉介入术, 心血管健康评分, 急性心肌梗死, 护理

Abstract:

Objective To investigate the characteristics of cardiovascular health score trajectories in patients after percutaneous coronary intervention（PCI）. Methods The convenience sampling method was used to recruit 339 acute myocardial infarction patients who underwent PCI for the first time in the cardiology department of a first-class tertiary hospital in Harbin from May to October 2019 with regular follow-up after PCI. We used the group-based trajectory model to identify the heterogeneous trajectory groups of cardiovascular health score based on the baseline,6 months and 12 months follow-up. The Cox proportional risk regression model was used to analyze the effect of trajectory groups and major adverse cardiac events（MACE）. Results 5 cardiovascular health score trajectories were identified as low-increasing group（19.8%）,medium-declining and then increasing group（24.8%）,medium-rapid increasing group（14.4%）,medium-stable group（31.9%）,high-stable group（9.1%）. Cox proportional risk regression model showed that,after adjustment for potential confounding factors（age,sex,high-density lipoprotein cholesterol and alcohol consumption）,the risk of MACE in medium-declining first and then increasing group,medium-rapid increasing group,medium-stable group and high-stable group were 0.498（P=0.033）,0.446（P=0.049）,0.403（P=0.006） and 0.259（P=0.030） times of low-increasing group,respectively. Conclusion Acute myocardial infarction patients after PCI for a year showed various cardiovascular health score trajectories;the improvement and maintainance of a high level of cardiovascular health score were negatively correlated with the risk of MACE. Medical staff can monitor the characteristics of cardiovascular health score changes dynamically,strengthen risk factor management and adopt early intervention methods to improve prognosis.

Key words: Percutaneous Coronary Intervention, Cardiovascular Health Score, Acute Myocardial Infarction, Nursing Care