| Objective To analyze the clinical outcomes of emergencypercutaneous coronary intervention(e-PCI) in acute myocardialinfarction(AMI) during hospital and follow-up period, and to analyze therelated risk factors affecting the prognosis.Methods The retrospective study was used. From January Ist of 2004to December 31st of 2005, emergency PCI was successfully performed incardiology department on 150 consecutive cases with AMI. Among them 134cases were followed up. According to whether cardiac events happened,cases were divided into two groups. The clinical factors were comparedbetween the two groups.Results1. Gender The cardiac event group comprised of 35 males (76.1%) and11 females (23.9%); the cardiac event-free group comprised of 61 males(69.3%) and 27 females (30.7%).The gender showed no significantdifference between the two groups (P＞0.05).2. Age The mean age was 63.33±12.17 yeas in the cardiac event groupwhereas 60.99±11.06 years in the cardiac event-free group. 19 patients'age were≥70 years in the cardiac event group, whereas 21 in the cardiacevent-free group. The age showed significant difference between the twogroups (P＜0.05).3. Past history In the total of 134 patients, there were 75 patients(55.97%) with a history of prior hypertension; 20 patients (14.93%)with a history of prior diabetes mellitus(DM); 83 patients (61.94%)with a history of prior angina pectoris; 21 patients (15.67%) with ahistory of prior stroke; 44 patients (32.84%) with a history of priorcoronary heart disease; 11 patients(8.2%) with a history of prior obsolete myocardial infarction(OMI). The foregoing factors showed nosignificant difference between the two groups (P＞0.05).4. Other factors In the total of 134 patients, there were 63 patients(47.01%) with a history of prior smoking: 34 patients (25.37%) witha history of prior drinking: 31 patients (23.13%) with a prior familyhistory. The foregoing factors showed no significant difference betweenthe two groups (P＞0.05). The levels of TG, TC, LDL-C and HDL-C showed nosignificant difference between the two groups (P＞0.05).5. Hospitalization The mean hospitalization was 11.85±3.77 days inthe cardiac event group whereas 10.86±3.65 days in the cardiac event-freegroup. The hospitalization showed no significant difference between thetwo groups (P＞0.05).6. Symptom-to-door time The mean symptom-to-door time was 4.08±3.27hours in the cardiac event group whereas 3.36±1.83 hours in the cardiacevent-free group. The symptom-to-door time showed no significantdifference between the two groups (P＞0.05).7. Symptom-to-balloon time The mean symptom-to-balloon time was 7.71±3.77 hours in the cardiac event group whereas 5.76±1.99 hours in thecardiac event-free group. The symptom-to-balloon time showed significantdifference between the two groups (P＜0.05).8. Echocardiogram The left atrial end diastolic dimension(hAEDD)showed significant difference between the two groups (P＜0.05). The leftventricular ejection fraction(LVEF), the left ventricular end diastolicdimension(LVEDD),the right ventricular end diastolic dimension(RVEDD)and the regional wall motion(RWM) showed no significant differencebetween the two groups (P＞0.05).9. Angiography and PCI The patients with angiography of multi-vessellesion, the infarction related artery(IRA) in LAD have a higher risk of cardiac events (P＜0.05).Conclusions1. Age is an important predictor of cardiac events in the short-term offollow-up. Elderly patients have a higher risk of cardiac events.2. Symptom-to-balloon time is an important predictor of cardiac eventsin the short-term of follow-up. Improving public awareness andaccessibility of health services to patients with AMI is essential inreducing poor outcomes.3. Multi-vessel coronary disease is an important predictor of cardiacevents in the short-term of follow-up.4. Patients with infarct related artery in left anterior descendingartery have more cardiac event than in right coronary artery.5. Fibrinogen is an important predictor of cardiac events in theshort-term of follow-up.
|
PDF Full Text Request