关键词: 心肌梗死, 急性, 二级预防, 老年人

Abstract: Objective To investigate the situation of the secondary prevention and analyze the influencing factors on secondary prevention and explore the relationship between secondary prevention and major adverse cardiac events (MACE) among the elderly patients after acute myocardial infarction (AMI). Methods In this retrospective study, a total of 107 hospitalized elderly survivors (73 male, 34 female) with ST-segment elevation myocardial infarction (STEMI) were enrolled from October 2009 to July 2010 in Beijing Lube Hospital, the mean age was 66.54±6.19 (60 to 84) years. All the cases were followed up in clinic in January 2011,follow-up time was 6 to 15 months.According to the situation of secondary prevention, 107 cases were divided into two groups: good secondary prevention group (45 cases) and poor secondary prevention group (62 cases). The influencing factors on secondary prevention were analyzed and the incidence of MACE of the two groups were compared.Results The situation of secondary prevention of 42.1% of patients was well. A stepwise logistic regression analysis further suggested the following independent predictors to secondary prevention: the degree of receiving health education (OR=9.14,95%CI: 1.57~53.31), type of medical insurance(OR=9.32, 95%CI:1.80~48.22). The incidence of MACE and clinical events of good secondary prevention group was significantly lower than the poor secondary prevention group (8.9% vs 40.3%, 17.8% vs 57.8%, P﹤0.05). Conclusion The secondary prevention in elderly patients with acute myocardial infarction after discharge is not optimistic, and there was a wide gap to the guideline of AMI. The type of medical insurance and the degree of receiving health education were independent variables to predict the secondary prevention. Good secondary prevention can significantly reduce major adverse cardiac events.

Key words: myocardial infarction, acute, secondary prevention, elderly people