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在急性心肌梗塞患者的24小时血压变化和死亡率之间的关系
Ying Liu1,2, Wen Li1,2, Shuoyan An1
1Department of Cardiology, China-Japan Friendship Hospital, Beijing, China.
Clinical cardiology
|April 2, 2024
概括
在急性心肌梗塞 (AMI) 患者中,高血压的变化与增加的死亡率有关. 在最初的24小时内,高和低的透气血压变化 (DBP-ARV) 都预测了更高的短期和长期死亡风险.
科学领域:
- 心脏病学 心脏病学
- 关键护理医学 关键护理医学
- 临床研究 临床研究
背景情况:
- 急性心肌梗塞 (AMI) 的死亡率仍然很高.
- 血压变化 (BPV) 和AMI结局之间的关联还没有得到很好的定义.
研究的目的:
- 调查24小时BPV与AMI患者死亡率之间的关系.
- 为治疗策略提供信息,以减少AMI中的死亡风险.
主要方法:
- 使用MIMIC-IV 2.0数据库进行回顾性队列研究.
- 在AMI患者的ICU入院后的前24小时内血压的计算平均真实变化 (ARV).
- 分析了使用考克斯回归,卡普兰-梅尔和限制立方脊柱 (RCS) 曲线的30天,1年和3年的全因死亡率.
主要成果:
- 较高的透析血压变化率 (DBP-ARV) 与30天,1年和3年死亡率的增加显著相关.
- 系统性血压变化 (SBP-ARV) 并没有预测死亡率.
- 卡普兰-梅尔曲线显示,具有最高ARV的患者的生存概率较低.
- RCS曲线表明DBP-ARV和死亡风险之间存在复杂的关系,在较低和较高的ARV值时,风险增加.
结论:
- 在AMI患者的ICU护理最初24小时内,DBP-ARV升高与更高的短期和长期死亡率有关.
- 过度高和过低的DBP-ARV都可能表明AMI患者的风险增加.
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