| ObjectiveTo analyze the affecting factors of the heart function by comparing heart functionof the patients with AMI after PCI (including emergency and elective) at differenttimes.MethodThis study chose269cases of hospitalized patients with initial STEMI (male210,female59cases), all underwent PCI, infarction related artery (IRA) TIMI0level age29-89years old. All patients took conventional medicine regularly after PCI, and ifthere were no contraindications, drugs for preventing myocardial remodeling weremaximum tolerance. To calculate coronary vascular lesions counts, Gensini score andevaluate coronary TIMI grading according to the results of the coronary angiographycoronary，we measured left ventricular ejection fraction, left ventricular diameter, andplasma levels of NT-proBNP and cTnI at different time points after the onset.Moreover，we grouped the object of study by the change of NT-proBNP concentrationto compare the cardiac function, analyzed the influence factors of cardiac functionthrough the emergency PCI group of patients, and investigated the correlation ofNT-proBNP, LVEF and LVEDD by the analysis of them.Result1. AST concentration(209.68±155.30vs115.56±104.72, P<0.001), Gensiniscore(74.61±27.63vs61.13±30.23, P<0.001), Killip gradation(P<0.001) showedstatistical significance between the two groups. While vascular lesion counts(P<0.080)has no statistical significance. The data in smoking was1.385times larger than that ofnon-smoking patients.2. In emergency PCI group, AST concentration also showed statistical significance between the two groups(221.57±155.41vs167.55±120.04, P=0.030).Before treatment delayed time of increase of NT-proBNP was5.68±3.02h and thetime of reduce of NT-proBNP was4.66±2.27h. The difference had statisticallysignificant between the two groups(P=0.034). The patients in anterior wall AMIwould be at higher risk for NT-proBNP rising(P=0.031). The data of emergencysurgery patients with anterior wall AMI was2.099times that of inferior wall AMI. Gensini score(75.69±26.62vs63.14±26.70, P=0.005) and the peak value ofTnI(130.5(53.13,210.50) vs73.40(30.70,129.00), P=0.002) in NT-proBNP risinggroup were significantly higher than that of the other group. Killip gradation(P=0.039)and vascular lesion counts(P=0.033) also showed significantly difference between thetwo groups.3. There was significantly positive correlation between plasma level ofNT-proBNP and LVEDD, and there was significantly negative correlation betweenplasma level of NT-proBNP and LVEF in patients(P<0.05). The three changes inSTEMI patients with early value and30days after AMI still present the relationship,and the result showed statistical significance(P<0.05).Conclusion1. The patients of smoking, anterior wall AMI, before treatment delayed timelonger, higher peak value of TnI, higher Gensini score, higher Killip gradation will beat higher risk for NT-proBNP rising after AMI.2. Vascular lesion counts may play a predictive value for the orgin of heartfailure in AMI patients who undergo emergency PCI but not for selective PCI.3. NT-proBNP and echocardiography result have consistency in predicting heartfailure occurring Days30after AMI. |
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