摘要
Abstract
Objective To investigate the risk factors for ventricular arrhythmias(VA)in elderly patients with acute myocardial infarction(AMI)after emergency percutaneous coronary intervention(PCI),and to develop a risk pre-diction model.Methods A retrospective analysis was conducted on 150 elderly patients(≥60 years)with AMI who underwent emergency PCI at Longyan First Hospital from January 2022 to December 2024.Based on the occurrence of VA within 7 days after surgery,patients were divided into the VA group(n=38)and the non-VA group(n=112).Baseline data,electrocardiographic parameters(fragmented QRS duration,frontal QRS-T angle),and inflammatory markers[neu-trophil-to-lymphocyte ratio(NLR)]were collected and compared between the two groups.Univariate and multivariate logistic regression analyses were used to identify independent risk factors for VA,and a prediction model was constructed accordingly.The predictive performance of the model was evaluated using the receiver operating characteristic(ROC)curve.Results Among the 150 patients,the incidence of postoperative VA was 25.33%(38/150).Multivariate logistic regression analysis showed that preoperative Killip class Ⅲ～Ⅳ(OR=3.495,95%CI:1.155～10.574),prolonged fragmented QRS duration(OR=1.066,95%CI:1.008～1.127),increased frontal QRS-T angle(OR=1.123,95%CI:1.069～1.179),and elevated NLR(OR=1.544,95%CI:1.209～1.973)were independent risk factors for VA in elderly AMI patients after emer-gency PCI(P<0.05).The prediction model based on these factors was:Logit(P)=-19.909+1.251×preop-erative Killip class+0.064×fragmented QRS duration+0.116×frontal QRS-T angle+0.435×NLR.The area under the ROC curve for this model in predicting VA was 0.920(95%CI:0.861-0.978).Conclusion Cardiac dysfunction(high Killip class),abnormal myocardial electrical conduction(prolonged fragmented QRS duration,increased QRS-T angle),and systemic inflammatory response(elevated NLR)are important risk factors for VA in elderly AMI patients after emer-gency PCI.The prediction model integrating these indicators demonstrates good discriminative ability,which may assist in early clinical identification of high-risk patients.关键词
急性心肌梗死/老年/经皮冠状动脉介入术/影响因素Key words
acute myocardial infarction/elderly/percutaneous coronary intervention/influencing factors
