Clinical Investigation On The Influencing Factors And Prognosis Study Of Spontaneous Reperfusion Of Infarction Related Artery In Patients With Acute Myocardial Infarction

Objective:After patients with ST-segment elevated myocardial infarction underwent emergent coronary angiography,some patients were spontaneous reperfusion of infarction related artery,others were non-spontaneous reperfusion of infarction related artery.Clinical characteristics and prognosis of patients in the spontaneous reperfusion group were different from the non-spontaneous reperfusion group.In this study,we explored the influence of spontaneous reperfusion in acute ST segment elevation myocardial infarction,and discovered its association with the spontaneous reperfusion,and prognosis in hospital and at 12-month follow-up.Methods:661 patients with initial STEMI in succession in the cardiovascular department of the First Affiliated Hospital of Jilin University from January 1 to December 31 in2015 were enrolled and underwent emergent coronary angiography.The patients in the spontaneous reperfusion group were 164,and patients in the non-spontaneous reperfusion group were 497.Clinical baseline characteristics,laboratory examination results,echocardiography result,coronary angiography results and the major adverse cardiac events were recorded in hospital.Then the major adverse cardiac events were compared at 12-month follow-up between the two groups.Results:1.A total of 661 patients were eligible for analysis.The coincidence rate of the spontaneous reperfusion patients was 24.81 %.2.Patients in the spontaneous reperfusion group had lower level of random blood glucose after admission,blood glucose,peak troponin I,aspartate aminotransferase and alanine aminotransferas,higher level of mononuclear cells,lower incidence of coronary collateral circulation,longer time from morbidity to the coronary artery angiography,lower incidence of wall motion abnormality,with higher left ventricle ejection fraction,more proportion with higher Killip grade,as compared to the NSR group,and the above differences were statistically significant(P < 0.05).Strong correlation was found among peak troponin I level,coronary collateral circulation,wall motion abnormality and spontaneous reperfusion based on Logistic regression analysis.3.In contrast with the non-spontaneous reperfusion,patients in the spontaneous reperfusion group had lower incidence of the major adverse cardiac events in hospital,and the differences were significant(P<0.05).4.Kaplan-Meier survival analysis demonstrated that the rate of the major adverse cardiac events-free survivals in the spontaneous reperfusion group was higher at12-month follow-up,but no significant differences were found between the two groups(P>0.05).Conclusion:1.Higher peak troponin I,coronary collateral circulation establishment and wall motion abnormality were related factors for non-spontaneous reperfusion patients.2.In contrast with the non-spontaneous reperfusion,patients in the spontaneous reperfusion group had better outcomes in hospital.3.The rate of the major adverse cardiac events-free survivals in the spontaneous reperfusion group was higher at 12-month follow-up,but no significant differences were found between the two groups.