Clinical features and in-hospital adverse events risk of acute coronary syndrome patients with cerebral ischemic stroke history

Kang Yunpeng; Liu Wenxian; Zhu Jiajia; Chen Liying

doi:10.3760/cma.j.issn.1673-4777.2017.06.005

Abstract：Objective To investigate clinical features and risk factors of in-hospital adverse events in acute coronary syndromes(ACS) patients with cerebral ischemic stroke history.Methods Totally 5 685 patients with ACS from April 2002 to March 2016 in Beijing Anzhen Hospital,Capital Medical University were retrospectively analyzed;423 patients who had ischemic stroke history were allocated to observation group,5 262 patients without stroke history were allocated to control group.General information and clinical indexes within 24 h after admission were recorded;features of coronary lesions and occurrences of in-hospital adverse events were analyzed.Risk factors of adverse events were analyzed by multivariate logistic regression.Results Age,systolic blood pressure,levels of hemoglobin,creatinine,uric acid,ratios of hypertension history,diabetes history and smoking history in observation group were significantly higher and left ventricular ejection fraction [(56 ± 12)％ vs (58 ±13)％] were significantly lower than those in control group(P ＜ 0.05).Rate of multiple vessel lesions in observation group was significandy higher than that in control group [11.3％ (48/423) vs 8.8％ (465/5 262)] (P ＜0.05).Multivariate logistic regression analysis showed that ischemic stroke history (odds ratio =1.861,95％ confidence interval:1.16-2.98,P =0.010),diabetes history(odds ratio =1.224,95％ confidence interval:1.04-1.44,P=0.001) and ＞65 years of age(odds ratio =4.580,95％ confidence interval:3.22-6.50,P＜0.001) were independent risk factors of in-hospital adverse events.Conclusions Patients with ACS with a history of ischemic stroke usually have extensive coronary lesions.Ischemic stroke history,advanced age and diabetes history are independent risk factors of in-hospital adverse events in ACS patients.