Early Diagnosis And Prognosis Analysis Of Patients With Acute Cardiac Infaction Combined With Chronic Total Occlusion

Objective:To discuss the chronic total occlusion disease (CTO) combined with acute cardiac infaction, find the new marks of early diagnosis. And to investigate the prognostic factors in these patients after get the percutaneous coronary intervention(PCI).Methods:During January2012to January2015,68patients who received the primary percutaneous coronary intervention with chronic total occlusion in our center were admitted in this study. Twenty patients combined with acute cardiac infaction history. The endpoint of follow-up for all of the surviving patients were February2015. We compared and analyzed the differences of survival, including the symptom relapses, blood test, left ventricle ejection fracton(LVEF), aiming to evaluate their prognosis after PCI. We also explored the new blood markers to early diagnosis and investigated prognostic factors in all patients.Results:1. The clinic baseline characters between CTO+MI group and CTO group was no significantly differences, but the symptom of chest pain in CTO+MI group was significantly higher. One month after PCI, the relapse of chest pain in two groups was no significantly differences; three month after PCI, CTO group was much higher.2. The secondary PCI rate in one month CTO+MI group was significantly higher than CTO group, and this was associated with the relapse of symptom.3. Comparing the blood markers:(1) HbAlc%and NT-proBNP between two groups was no significantly difference;(2)for BUN/SCr, before PCI CTO+MI was lower; dividing the patients into two subgroup success PCI group and failed group, the BUN/SCr in success group was much lower.4. Neutrophil-to-lymphocyte(NLR) as one inflammation markers, comparing in two groups, we found before procedure CTO+MI group was significantly higher, but follow-up, the trend was going lower; CTO group was no significantly difference.5. The left ventricle ejection fraction:before procedure CTO group was significantly higher. Using Logistic analysis, we found that LVEF<60%before PCI (p=0.003, OR::8598,95%CI4.153-52.345) was one prognosis factor.Conclusion:BUN/SCr and NT-proBNP may predict the presence of CTO combined with acute cardiac infaction, but additional studies with more patients are required to confirm this. NLR can as one early diagnosis markers but the sensitivity and specificity are required to make sure. LVEF<60%before PCI was one prognosis factor.