The Influencing Factors And Clinical Analysis Prognosis Of STEMI Door To Balloon Time

Objective:Through the analysis of the present situation of acute ST segment elevation myocardial infarction patients door to balloon time, to explore the related factors of opening time delay and possible solutions. Through the comparative study gets the effect of door to balloon time on clinical prognosis.Methods:To review the basic data of354cases acute ST segment elevation myocardial infarction patients who had direct percutaneous coronary intervention therapy in Tianjin Thoracic Hospital from January2012to March2013, according to the door to balloon time patients were divided into two groups (group A <90minutes, B group>90minutes). Using logistic regression analysis of related factors, in order to determine the factors related to door to balloon time delay. After1weeks and6months,the patients took the sultrasonic Heartbeat graph examination, left ventricular end diastolic diameter (LVED) and left ventricular ejection fraction (LVEF). Those patients were telephoned follow-up6months,record the of major adverse cardiac events (MACE) mainly consists of all-cause death, nonfatal myocardial infarction, target vessel revascularization (TVR).Impact assessment of door to balloon time on clinical prognosis.Results:1.The factors of door to balloon time obviously delayed were other hospital transfer (P<0.01) and hospitalization in non normal working time (P<0.01), in addition the advanced age of patients was a factor of caused by door to balloon time delay (P=0.013).2. After1weeks, left ventricular end diastolic diameter of group A and group B showed no significant difference (51.57±4.76vs52.93±5.60,P=3.991), but left ventricular ejection fraction of group A was significantly higher than that in group B (58.47±6.98vs52.26±9.01,P=0.026).After6months follow-up, the left ventricular end diastolic diameter in group A was obviously less than group B (52.15±4.87vs55.86±4.98,P=0.032), but no significant differences in left ventricular ejection fraction of group A and group B (58.84±7.68vs57.42±6.85,P=2.961). The total of MACE evenst were25cases, including3cases of group A(3.70%),22cases of group B(8.94%),2cases of death, including1cases of group A (0.93%),2cases of group B(0.81%),17cases of non fatal myocardial infarction, including2cases of group A(1.85%),15cases in group B(6.10%),6cases of target vessel revascularization, including1cases of group A (0.93%),5cases of group B(2.03%), total MACE events in group A were lower than that in group B (3.70%vs8.94%,P=0.04).Conclusion:1. Other hospital transfer, hospitalization in non normal working time and the advanced age were the main factors cause the door to balloon time delay. At present, STEMI door to balloon time was delayed in domestic and foreign, we should be combined with the specific situation in the region, to further explore the feasible methods and measures to reduce the STEMI door to balloon time.2. To reduce door to balloon time can improve the recent heart function and long-term ventricular remodeling,less MACE events,improve the survival rate of non MACE events in acute myocardial infarction. Patients. Door to balloon time and clinical effect have a close relationship.