根据左心室功能和心力衰竭症状,心肌梗塞后的存活率
Jarle Jortveit1, Peder L Myhre2,3, Kristian Berge3,4
1Department of Cardiology, Sorlandet Hospital, Arendal, Norway.
ESC heart failure
|March 18, 2025
概括
在急性心肌梗塞 (AMI) 后,左心室喷射率 (LVEF) 减少的患者面临更高的死亡率. 出院时的心力衰竭症状显著增加死亡风险,特别是在那些保持LVEF的人群中.
科学领域:
- 心脏病学 心脏病学
- 临床医学 临床医学
- 公共卫生 公共卫生
背景情况:
- 左心室 (LV) 功能障碍是急性心肌梗塞 (AMI) 后的常见并发症,即使没有明显的心力衰竭 (HF) 症状.
- 以前的试验表明,在AMI后的LV功能障碍中,事件率较低,需要对现实世界结果进行评估.
研究的目的:
- 评估患者在AMI后的现实世界流行和结果.
- 根据左心室喷射率 (LVEF) 和HF症状的存在来分层结果.
主要方法:
- 一项使用挪威心肌梗塞注册表 (2013-2022) 数据的队列研究.
- 分析包括使用卡普兰-梅尔曲线,生命表和考克斯回归模型的短期和长期全因死亡率.
主要成果:
- 在70,809名AMI患者中,13.3%的LVEF降低 (≤40%),其中63.2%的HF有症状.
- 一年死亡率因LVEF和HF症状而有显著差异,在症状患者中,LVEF降低的患者死亡率达到20.2%.
- 与无症状患者相比,症状患者的死亡风险更高 (调整HR为1.15-1.85),超过LVEF类别的无症状患者.
结论:
- 降低AMI后的LVEF与相当大的1年死亡率有关,超过最近的试验中发现的死亡率.
- 住院期间心力衰竭症状会加重结果,特别是在LVEF保持的患者中,但对已经减少LVEF的患者来说风险更小.
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