Theanalysis Of Related Factors Influencing The Spontaneous Reperfusion Afteracute Myocardial Infarction

Objective: To study the influencing factors of the spontaneousreperfusion (SR) after acute myocardial infarction.Contents and methods: From Mar2007to Jun2012, there were382patients with acute myocardial infarction (AMI) staying in the NO.3People’s Hospital of cardiovascular medicine, who had been givenpercutaneous coronary intervention (PCI) surgery directly. By coronaryangiography(CAG),124patients with a TIMI grade of2~3were enrolledto SR group． Another258patients with a TIMI grade of0~1wereenrolled to NSR group．Then we collected the general clinical records of382patients with acute myocardial infarction, including: gender, age,smoking history, history of hypercholesterolemia, diabetes andhypertension, blood pressure, heart rate, killip classification, cholesterollevel, myocardial enzyme, the success rate of PCI, lesions of bloodvessels and the quantity，the use of tirofiban before PCI or not,and thenanalyse the above data.Results: Single factor analysis showed that age, gender, hypertensionhistory, diabetes history, history of hypercholesterolemia, rate ofsuccessful PCI and pathological changes blood vessel and the quantity have no obvious statistical differnece with the spontaneous reperfusion.Smoking proportion was obviously higher in NSR group than that in SRgroup, the difference was statistically significant (p <0.001). Killip Ilevel, the proportion of the SR group was obviously higher than that ofthe NSR group, the difference was significant (p<0.001); In killipIIIlevel, NSR proportion was higher than the SR group (p=0.009). Thehigh density lipoprotein (HDL) in the SR group (1.47±0.18mmol/L) washigher than that in the NSR group (1.38±0.26mmol/L), the differencewas significant (p <0.001). Low density lipoprotein (LDL) in the SRgroup (2.09±0.43mmol/L) was lower than that in the NSR group (2.25±0.71mmol/L), which had significant difference (p<0.001). The peaklevels of CK and CK-MB in the SR group were lower than that in theNSR group, both had statistical significance (p=0.04, p=0.006).Compared with the NSR group (74.39+13.29mmHg), the diastolicblood pressure in the SR group (76.26+13.38mmHg) was significantlyhigher (p=0.038). Multi-factor analysis showed that smoking,LDL,HDL,killipI and Lpa had significant relationship with SR(p<0.05). Compared with the rate of that in patients who didn’t usetirofiban with17.07%,the rate of spontaneous reperfusion in the patientswho used tirofiban with36.67%was significantly different by Chi-squaretest (p＜0.05). Conclusions: Our results showed that spontaneous reperfusion in infarctrelated artery after AMI may be ascribed to smoking, LDL, HDL, Lpa,diastolic blood pressure. And tifofiban can increase the rate ofspontaneous reperfusion.