摘要
目的评估非甾体类抗炎药（NSAIDs）对心肌梗死后患者心血管事件发生的影响。方法回顾性分析182例心肌梗死患者的临床资料，依据出院后服药差异分为：观察组，87例，长期服用选择性NSAIDs；对照组，95例，仅服用阿司匹林或氯吡格雷。随访1年后，比较两组患者高血压、接受血运重建术、2级以上心力衰竭以及猝死等心血管事件的发生率；并用Cox风险比例模型分析NSAIDs与心血管事件发生率的相关性。结果观察组患者高血压、接受血运重建术、2级以上心力衰竭及猝死的发生率显著高于对照组，分别为13．79％（12／87）和9．47％（9／95）、14．94％（13／87）和10．64％（10／95）、22．99％（20／87）和12．63％（12／95）、3．44％（3／87）和2．10％（2／95，P均〈0．05）。服用NSAIDs使心肌梗死后患者心血管事件的发生率显著增加，分别为：高血压（OR=1．48，95％CI：1．26-1．69）、接受血运重建术（OR=1．33，95％CI：1．17—1．53）、2级以上心力衰竭（OR=1．84，95％CI：1．49～2．06）及猝死（OR=1．42，95％CI：1．29—1．68）。结论心肌梗死后患者服用选择性NSAIDs会显著增加患者心血管事件发生风险。
Objective To evaluate the effect of nonsteroidal anti-inflammatory drugs （NSAIDs） to the risk of cardiovascular events in patients with post-myocardial infarction （MI）. Methods The 182 patients with post-MI were divided into the two groups, research group （87 cases, long-term taken NSAIDs） and control group （95 cases, just taken aspirin or clopidogrel）, according to the difference of medication after discharge. After one year follow-up, the rates of hypertension, revascularization, class 2 or above heart failure（HF） and sudden death were compared between two groups. The relativity of long-term taken selectivity NSAIDs and cardiovascular events risk was analyzed by Cox proportional hazard model. Results The rates of hypertension, revascularization, class 2 or above heart failure （HF） and sudden death in research group were higher than in control group, 13.79% （ 12/87 ） vs 9.47% （ 9/95, P = 0. 026）, 14.94% （ 13/87 ） vs 10.64% （ 10/95, P = 0. 029 ）, 22.99% （ 20/87 ） vs 12.63 % （ 12/95, P = 0. 018 ） ,3.44% （3/87） vs 2.10% （2/95 ,P = 0.005 ） respectively. The cardiovascular events risks in pa- tients with post-MI were increased significantly after long-term taken selectivity NSAIDs, （ OR = 1.48, 95%CI：1.26-1.69; OR = 1.33,95% CI： 1. 17-1.53; OR = 1.84,95% CI： 1.49-2.06; OR = 1.42, 95% CI ： 1.29-1.68） respectively. Conclusion The risk of cardiovascular events in patients with post-MI is increased significantly after long-term taken selectivity NSAIDs.
出处
《临床内科杂志》
CAS
2013年第8期533-535,共3页
Journal of Clinical Internal Medicine
关键词
心肌梗死
非甾体类抗炎药
心血管事件
Myocardial infarction
Nonsteroidal anti-inflammatory drugs
Cardiovascular events
