An Analysis About Risk Factors Of Malignant Ventricular Arrhythmias At The Early Stage Of St-elevation Myocardial Infarction

Objective：The aims of this study are to explore the risk factors ofmalignant ventricular arrhythmias(MVA) at the early stage of thereperfusion therapy of ST-elevation myocardial infarction(STEMI)，meanwhile to iestablish predictive implications。Methods：302STEMI patients were involved in this study and allpatients underwent primary percutaneous coronary intervention(PCI)。The patients were divided into MVA group(n=38) and no MVAgroup(n=264) based on the presence or absence of MVA within48hoursafter PCI。Firstly，we search for the risk factors with statistical significanceby univariate analysis between MVA group and no MVA group。Then thoseMVA-influenced factors after STEMI with p value less than0.1screenedfrom univariate analysis were further assessed by multiple logisticregression analysis。Results：38patients of all are presence of MVA.By the univariate analysis we find that the WBC count（12.442±4.174×10~9/Lvs9.469±3.494×10~9/L,P=0.000）、Neutrophil count(9.863±3.690×10~9/L vs7.435±3.233×109/L，P=0.000)and the serum glucose level (10.946±3.415mmol/L vs8.375±3.498mmol/L，p=0.002) on admission was higher in patients withMVA than in those with no MVA， the serum potassium level(3.255±0.432mmol/Lvs3.730±0.585mmol/L，P=0.009)on admission waslower in patients with MVA than in those with no MVA，moreover diabetesmellitus (31.6%vs17.4%，P=0.038)and the Killip Ⅳclass（21.1%vs9.8%，P=0.041）was more common in patients with MVA than in those without。Multivariate analysis revealed that the elevate WBC count、the elevateNeutrophil count、the increased serum glucose level and hypokalemia onadmission、the Killip Ⅳclass were the independent risk factors of MVA atthe early stage of the patients with STEMI treated with PCI。The ROCcurves of the WBC count、Neutrophil count、the serum glucose level andthe serum potassium level on admission revealed that the area under thecurves were0.724、0.701、0.775、0.755，respectively,and the cutoffs inpredicting MVA occurred at the early stage of PCI respectively were11.040×10~9/L、8.115×10~9/L、9.58mmol/L and3.13mmol/L。Conclusion：The elevate WBC count、the elevate Neutrophil count、the increased serum glucose level and hypokalemia on admission、the KillipⅣclass are the independent risk factors of MVA at the early stage of thepatients with STEMI treated with PCI，and they can predict the development of MVA at the early stage of reperfusion therapies with PCI。...