| Background and purpose： Acute coronary syndrome, is a kind of clinical syndromewhich is caused by acute myocardial ischemia, including unstable angina，non-ST-segment elevation myocardial infarction (MI) and ST-segment elevationmyocardial infarction. its incidence is increasing in recent years according to thedomestic data, the most harmful one is ST-segment elevation myocardial infarction. Thecurrent guidelines recommend that the patients with acute ST segment elevationmyocardial infarction should choose the percutaneous coronary artery interventiontreatment first under condition, but it’s hard to predict the occurrence of fatal, malignantarrhythmias, for example, electrical storms, for the patients in peri-operative ofintervention therapy, This is also the main cause of emergency PCI in patients withpostoperative deaths,so this study is to predict the relative risk of electrical storms inperi-operative of intervention therapy for the patients of ST segment elevation acutemyocardial infarction who are in Emergency of percutaneous coronary intervention, Toreduce the mortality of patients in peri-operative with percutaneous coronaryintervention of acute ST-segment elevation myocardial infarction.Methods: By analyzing the Clinical data retrospectively from the253patients withacute ST segment elevation myocardial infarction who are in emergency in Firstaffiliated Hospital of Dalian Medical University during March2012to March2014, toseparate groups according to the symptom whether they suffered the storm ventricular arrhythmia in peri-operative, Grouping the patients who did not suffer it as ComparisonGroup, while the patients who suffered it as Electrical Storm Group. Electrical storm isdefinite as acute severe syndrome, with malignant arrhythmia caused severehemodynamic disorder malignant arrhythmia above or equal than twice in1day.Including ventricular tachycardia/ventricular fibrillation, who need the electroversionor electric defibrillation immediately.Results:253cases of emergency PCI patients were included in this study, including52in Electrical Storm Group,201in Comparison Group. The incidence is20.6%. thepercentage of left main lesion led in electrical storm is the largest,54%, and theincidence of the blood vessels, including the anterior descending coronary artery, leftand right of the left circumflex branch in peri-operative patients with electrical storm,is46%.The percentage of age, creatine kinase isoenzyme, allergic troponin T, BNP, renalinsufficiency, white blood cell count, random blood glucose, re-perfusion arrhythmiaincidence and case fatality were all higher than Comparison Group (p values were0.04,<0.01,<0.01,<0.01,0.01,0.02,0.01,0.01,<0.01). While there was no statisticallysignificant difference with gender, systolic pressure, diastolic pressure, electrolytes inbetween the two groups.Logistic regression analysis showed that the multiple factors of re-perfusionarrhythmia (OR:10.89,95%CI:4.13±29.98), BNP (OR:2.00,95%CI:2.00,1.00±3.92), renal insufficiency (OR:1.000,95%CI:1.00±1.873) is independent factorsassociated to emergency PCI peri-operative acute myocardial infarction occurred withelectrical storm.Conclusion：The electrical storm occurs mostly from Infarction related artery for theleft main patients with acute ST segment elevation myocardial infarction. And the majorrisk factor for peri-operative electrical storm is re-perfusion arrhythmia, BNP, renalinsufficiency. |
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