Risk Factors Of Acute ST-segment Elevation Myocardial Infarction Patients Presenting With Heart Failure

[Objective] To analyze clinical characteristics of acute ST-segment elevation myocardial infarction(STEMI)patients presenting with heart failure,and to explore the risk factors predict heart failure in patients with STEMI.[Methods] A total of 425 patients with STEMI were admitted to Department of Cardiology of Union Hospital,Tongji Medical College,Huazhong University of Science and Technology from Jan 2014 to Dec 2017.The clinical data and prognosis of the patients during hospitalization were collected or recorded.According to whether they complicated with heart failure,subjects were divided into two groups: the heart-failure group and non-heart failure group.The relevant factors were compared between the two groups,and multivariate logistic regression analysis was performed to determine independent risk factors of heart failure in STEMI patients.[Results](1)There were 198(46.6%)in the heart failure group and 227(53.4%)in the nonheart failure group.Compared with the non-heart failure group,mean age of the heart failure group was higher(62.94±13.26 years vs.56.85±12.04 years,P <0.05),and the proportion of female patients was higher(24.7% vs.16.3%,P <0.05);Diastolic blood pressure,systolic bloodpressure,mean arterial pressure are all significantly reduced in the heart failure group,(P <0.05).The history of Chronic kidney disfunction and myocardial infarction was higher in the heart failure group,P <0.05.(2)In the heart failure group,the levels of C-reactive protein,cystatin C,uric acid,creatinine,WBC,and so on,were significantly increased than those in non-heart failure group(P <0.05).On the contrary,the hemoglobin,albumin are all significantly reduced,P <0.05.(3)The left ventricular end-diastolic diameter、left and right atrialdiameter of the heart failure group were significantly increased,while the left ventricular ejection fraction reduced,(P <0.05).There was no statistically significant difference in the number of coronary arteryinvolved between the two groups(P =0.821).(4)The incidence of atrial fibrillation,ventricular electric storms,ventricularaneurysm,ventricular tachycardia,ventricular fibrillation,ventricular arrhythmia,and death were significantly increased in the heart failure group(P <0.05).(5)The independent risk factors for heart failure development in acute STEMI patients were age(OR:0.977;95%CI:0.958-0.996),mean arterial pressure(OR:1.022;95%CI:1.006-1.039),ventricular arrhythmia(OR:10.759;95%CI:4.469-25.904),hemoglobin(OR:1.016;95%CI:1.003-1.028),left atrial dimension(OR:0.543;95%CI:0.358-0.823),left ventricular ejection fraction(OR:1.061;95%CI:1.037-1.086).[Conclusions](1)Multifactors contribute to the development of heart failure in acute STEMI patients.(2)Age,mean arterial pressure,ventricular arrhythmia,lowhemoglobin,left atrial dimension and left ventricular ejection fraction are independent risk factors of heart failure in patients with acute STEMI.