Risk factors for adverse clinical outcomes in STEMI patients based on the exploratory factor analysis
Zhao Qian
Men Li
Shan Chunfang
Song Ning
Zhang Jinyu
Zhu Jiajun
Yang Yining
Abstract：Objectives To investigate the risk factors for adverse clinical outcomes in patients with ST-segment elevation myocardial infarction(STEMI).Methods The prospective cohort study consecutively recruited ST-elevation myocardial infarction(STEMI)patients who attended the Department of Cardiology,the First Affiliated Hospital of Xinjiang Medical University during the period of January 2013 to June 2017 and underwent PCI within 12 h after the onset of chest pain.The clinical data,cardiovascular risk factors,laboratory test indicators and coronary artery lesions were collected,and long-term follow-up was conducted after discharge.The principal component factor extraction method was used to analyze the original variables,and the correlation between each factor and the clinical prognosis was analyzed by multivariate regression analysis.Results A total of 495 subjects were included.After factor analysis,7 common factors were extracted,and the cumulative contribution rate was 70.02%.A further stepwise multivariable logistic regression analysis was performed to assess the association between in-hospital mortality and potential confounding factors,factor 1 smoking,gender,and age(OR=2.668,95%CI:1.036～6.867,P=0.042)and factor 5 multivessel lesions and diabetes(OR=2.802,95%CI:1.286～6.106,P=0.009)was the independent risk factors for in-hospital deaths.After discharge from the hospital,470 STEMI patients were followed up with a median duration of follow-up 39 months and 135 patients(28.7%)developed MACE.Cox proportional hazards regression analysis confirmed that lipid level(HR=1.261,95%CI:1.026～1.549,P=0.027),multivessel lesions and diabetes(HR=1.306,95%CI:1.053～1.621,P=0.015),the level of MIF and CK-MB(HR=1.241,95%CI:1.012～1.521,P=0.037)was the independent predictor of MACE.Conclusions To improve the clinical prognosis for STEMI patients,comprehensive management should be carried out,including smoking cessation,weight control,lipid management and personalized guidance for patients with diabetes.As a new myocardial injury marker,MIF has a certain predictive value of the long-term prognosis for STEMI patients.
Keywords：Acute myocardial infarctionPercutaneous coronary interventionMacrophage migration inhibitory factor
Publication Date：2023-10-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 1180-1184,1188 )