The predictive role of postoperative carbon dioxide combining power for in-hospital mortality in elderly patients with ST-segment elevation myocardial infarction undergoing percutaneous coronary intervention

【摘要】 Background The prognosis of elderly patients with ST-segment elevation myocardial infarction（STEMI） is poor, and information on specific risk factors remains scarce. We aimed to investigate the prevalence and the prognostic impact of postoperative carbon dioxide combining power（CO₂CP） in elderly STEMI patients receiving PCI. Methods Patients ≥65 years old with the diagnosis of STEMI who had received PCI was retrospectively enrolled between January 2010 and April 2016 in the Guangdong Provincial People’s Hospital. The association between postoperative CO₂CP and in-hospital and 1-year mortality was evaluated. Results A total of 775 elderly patients with STEMI were included and divided into two groups according to the lower normal limits of CO₂CP: <22 mmol/L（n=180）, and ≥22 mmol/L（n=595）. The incidence of in-hospital death（12.2% vs. 4.2%, P<0.001）, acute kidney injury（25.0% vs. 13.3%, P<0.001） and major adverse clinical events（30.0% vs. 8.7%, P<0.001） were significantly higher in patients with a low CO₂CP. Multivariate logistic regression analysis showed an independent relationship between CO₂CP and in-hospital death [odd ratio（OR）: 0.88, 95% confidential interval（CI）: 0.80-0.97, P=0.010]. This relationship disappeared in one-year mortality [hazard ratio（HR）: 0.95, 95% CI: 0.89-1.01, P=0.116]. Conclusions Postoperative CO₂CP is a feasible predictor during hospitalization for elderly patients with STEMI receiving PCI. [S Chin J Cardiol 2024; 25（4）: 238-244]更多还原

【Abstract】 Background The prognosis of elderly patients with ST-segment elevation myocardial infarction（STEMI） is poor, and information on specific risk factors remains scarce. We aimed to investigate the prevalence and the prognostic impact of postoperative carbon dioxide combining power（CO₂CP） in elderly STEMI patients receiving PCI. Methods Patients ≥65 years old with the diagnosis of STEMI who had received PCI was retrospectively enrolled between January 2010 and April 2016 in the Guangdong Provincial People’s Hospital. The association between postoperative CO₂CP and in-hospital and 1-year mortality was evaluated. Results A total of 775 elderly patients with STEMI were included and divided into two groups according to the lower normal limits of CO₂CP: <22 mmol/L（n=180）, and ≥22 mmol/L（n=595）. The incidence of in-hospital death（12.2% vs. 4.2%, P<0.001）, acute kidney injury（25.0% vs. 13.3%, P<0.001） and major adverse clinical events（30.0% vs. 8.7%, P<0.001） were significantly higher in patients with a low CO₂CP. Multivariate logistic regression analysis showed an independent relationship between CO₂CP and in-hospital death [odd ratio（OR）: 0.88, 95% confidential interval（CI）: 0.80-0.97, P=0.010]. This relationship disappeared in one-year mortality [hazard ratio（HR）: 0.95, 95% CI: 0.89-1.01, P=0.116]. Conclusions Postoperative CO₂CP is a feasible predictor during hospitalization for elderly patients with STEMI receiving PCI. [S Chin J Cardiol 2024; 25（4）: 238-244]更多还原