Objective: To investigate the clinical features and change trend of patients with acute coronary syndrome(ACS) undergoing emergent percutaneous coronary intervention(PCI). Methods: In this retrospective study, we retrieved all medical records of 4 907 ACS patients who underwent emergent PCI in Fuwai hospital from January 1,2010 to December 31,2016. We analyzed the clinical features and change trend in these patients. According to clinical diagnosis, patients were grouped as ST-elevated myocardial infarction(STEMI) group (3 719 cases) and NSTE-ACS group (patients with non-STEMI and unstable angina, 1 188 cases). Results: The ACS patients were aged (59.5±11.8) years old. There were 3 772 males and 1 135 females. The annual number of ACS patients underwent emergent PCI increased from 412 patients in 2010 to 1 067 patients in 2016. The number of NSTE-ACS patients increased from 11.4% (47/412) in 2010 to 26.5% (283/1 067) in 2016. Compared with STEMI group, patients in NSTE-ACS group were significantly older ((61.2±10.9) years old vs. (58.9±12.1) years old,P<0.01).The percent of female patients (30.1% (358/1 188) vs. 20.9% (777/3 719), P < 0.01), history of hypertension (69.1% (821/1 188) vs. 60.4% (2 248/3 719,P <0.01), previous PCI (25.8% (307/1 188) vs. 12.4% (461/3 719), P <0.01), and previous coronary artery bypass grafting (3.0% (36/1 188) vs. 1.0% (37/3 719), P <0.01) were all significantly higher in NSTE-ACS group than in STEMI group. On the other hand, NSTE-ACS patients presented less chronic renal failure (2.9% (35/1 188) vs. 4.3% (173/3 719), P <0.05) and hepatic dysfunction (8.5% (101/1 188) vs. 13.3% (495/3 719), P<0.01) as compared to ACS patients. In coronary angiography, NSTE-ACS patients had a higher prevalence of left-main disease (14.0% (166/1 188) vs. 7.8% (291/3 719), P<0.012 5) and triple vessel disease (47.8% (568/1 188) vs. 43.5% (1 619/3 719), P<0.012 5). There were no differences in prevalence of diabetes mellitus (31.9% (1 187/3 719) vs. 34.8% (414/1 188),P>0.05) and acute renal failure (0.1% (38/3 719) vs. 0.6% (7/1 188),P>0.05) between STEMI group and NSTE-ACS group. Conclusions: This single center retrospective analysis reveals that there is an increasing trend of NSTE-ACS patients from 2010 to 2016. Furthermore, there are more high-risk clinical characteristics in NSTE-ACS patients than in STEMI patients.
目的： 探讨接受急诊经皮冠状动脉介入治疗（PCI）急性冠状动脉综合征（ACS）患者的临床特征和变化趋势。 方法： 采用回顾性研究方法，连续入选2010年1月1日至2016年12月31日在阜外医院接受急诊PCI的ACS患者4 907例，分析其临床特征和变化趋势。根据临床诊断，将ACS患者分为ST段抬高型心肌梗死（STEMI）组（3 719例）和非ST段抬高型ACS（NSTE-ACS）组（包括非STEMI和不稳定性心绞痛患者，共1 188例）。 结果： ACS患者年龄（59.5±11.8）岁，男性3 772例，女性1 135例。每年接受急诊PCI的ACS患者数由2010年的412例上升至2016年的1 067例。NSTE-ACS患者比例由2010年的11.4%（47/412）上升至2016年的26.5%（283/1 067）。与STEMI组患者比较，NSTE-ACS组患者年龄较大[（61.2±10.9）岁比（58.9±12.1）岁，P <0.05]，女性比例较高[30.1%（358/1 188）比20.9%（777/3 719），P<0.05]，合并高血压病比例较高[69.1%（821/1 188）比60.4%（2 248/3 719），P<0.05]，既往接受PCI[25.8%（307/1 188）比12.4%（461/3 719），P<0.05]和冠状动脉旁路移植术[3.0%（36/1 188）比1.0%（37/3 719），P<0.05]的比例较高，而合并慢性肾功能不全[2.9%（35/1 188）比4.3%（173/3 719），P<0.05]和肝功能不全[8.5%（101/1 188）比13.3%（495/3 719），P<0.01]的比例较低。与STEMI组患者比较，NSTE-ACS组患者冠状动脉左主干病变（14.0%（166/1 188）比7.8%（291/3 719），P<0.012 5）和三支病变（47.8%（568/1 188）比43.5%（1 619/3 719），P<0.012 5）的比例较高。STEMI组与NSTE-ACS组患者合并糖尿病[31.9%（1 187/3 719）比34.8%（414/1 188），P>0.05]和急性肾功能衰竭[0.1%（38/3 719）比0.6%（7/1 188），P>0.05]的比例差异均无统计学意义。 结论： 单中心回顾性分析显示，2010至2016年NSTE-ACS患者呈增多的趋势；与STEMI患者比较，NSTE-ACS患者高危临床特征更多。.
Keywords: Acute coronary syndrome; Percutaneous coronary intervention.