Clnical Features And Prognosis Of Acute Myocardial Infarction Caused By Circumflex Artery Occlusion

ObjectiveTo investigate the clinical features and prognosis of acute myocardial infarction(AMI)caused by left circumflex artery(LCX)occlusion,so as to improve the vigilance of acute myocardial infarction caused by left circumflex artery,and take reasonable strategies in early stage to improve the prognosis.MethodsContinuous collection patients from January 2016 to July 2020 in the first affiliated hospital of Chongqing Medical University Hospital with acute myocardial infarction,after screening inclusion criteria and exclusion criteria,there were 162 patients admitted,all patients underwent coronary angiography to confirm that the the left circumflex artery and right coronary artery was the culprit vessel,according to the criminal vessels divideded into the LCX group and right coronary artery(RCA)group.The characteristics,myocardial enzymes,echocardiography,ECG characteristics,coronary angiography results and prognosis were compared between the LCX group and the RCA group.ResultsThe proportion of Non-ST-segment elevation myocardial infarction(NSTEMI)and lateral wall myocardial infarction in LCX group was higher than that in RCA group(50.9%vs16.8%,21.8%vs9.8%;P<0.05),and the proportion of distal branch and obtuse marginal branch occlusion in LCX group was higher than that in the proximal branch of LCX(68.4%vs58.8%vs26.3%;P<0.05)).There was no statistically significant difference in prognosis between Left circumflex coronary artery-ST segment Elevation Myocardial infarction(LCX-STEMI)and Left circumflex coronary artery-Non-ST segment Elevation Myocardial infarction(LCX-NSTEMI)patients in the LCX group(P>0.05).The rates of symptoms of synsynp,cardiac function of Killip Ⅳ,ECG of acute inferior wall myocardial infarction,acute posterior wall myocardial infarction and atrioventricular block,PCI within 24 hours,readmission and death in RCA group are higher than those in the LCX group(11.2%vs1.8%,11.2%vs1.8%,60.7%vs30.4%,20.8%vs10.9%,19.6%vs7.3%,70.9%vs84.1%,24.3%vs10.9%,11.2%vs1.8%;P<0.05,respectively).There were no significant differences in clinical baseline characteristics,clinical symptoms,changes in myocardial enzyme spectrum and ultrasonography between 2 groups(P>0.05).ConclusionPatient with LCX occlusion is more likely to show NSTEMI and lateral wall myocardial infarction in ECG,while RCA occlusion is more likely to show inferior wall and posterior wall myocardial infarction,and more likely to complicate with atrioventricular block.The prognosis of patients with right coronary artery occlusion may be worse than that with left circumflex artery occlusion.There may be no significant difference in prognosis between patients with STEMI and those with NSTEMI in patients with left circumflex artery occlusion.