| Objective:This study is to investigate the prognosis of patients with influence of thecollateral circulation of acute ST segment elevation anterior myocardialinfarction treated by emergency PCI.Methods:This study Chooses patients with a diagnosis of anterior wall STEMI andtreated by emergency PCI surgery. according to the results of coronaryangiography,these patients are divided into collateral circulation group,non-collateral circulation group,and then recording the general clinical data oftwo groups of patients,relevant assay index,LVEF and LVDD,Killipclassification, the peak troponin I and other clinical data.After6months’follow-up,recording the Major adverse cardiac events,reviewed LVEF, LVDD.A total of90patients with complete follow-up,collateral circulation group has43cases,non-collateral circulation group has47cases, through statistics and contrast analysis of recorded data, the study canevaluate the influence of collateral circulation patients.Results:Collateral circulation and non-collateral circulation group comparison:Age, ischemia time, gender, history of diabetes, smoking history,family history of coronary heart disease,total cholesterol,triglycerides,HDL,bloodsugar,respectively(55.84±13.88VS55.06±10.50，6.95±2.44VS6.26±2.21，81.4%VS63.8%，11.6%VS19.1%，18.79±15.93VS16.51±15.54，25.6%VS23.4%，4.90±0.78VS4.67±0.5,1.86±0.95VS1.62±1.17,1.21±0.29VS1.21±0.29,7.18±2.63VS7.19±2.07), hospitalization LVDD (mm) was51.30±6.22VS49.53±5.20,hospitalization LVEF was47.91%±10.73%VS49.96%±9.76%, the above datathere was no statistically significant difference between the two groups (P>0.05).Two groups of patients with a history of hypertension was25.6%VS25.6%,(P=0.008), angina occurred before infarction was67.4%VS38.3%(P=0.006),LDL-C was2.90±0.52VS3.41±0.83mmol/L (P=0.001); Killip classificationcomparison was39.5%VS61.6%(P=0.036), hospitalization CTnI peak was79.79±48.03VS102.58±53.06(P=0.025), LVDD check after half an year was47.04±3.66VS49.28±4.30（P=0.012）; LVEF check after half an year was55.49%±5.04%VS52.09%±5.68%(P=0.005). MACE was40.4%VS40.4%,(P=0.046), All of these have statistically significant differences.Non-collateral circulation groups:Hospitally and6months follow-up reviewed LVDD comparison was49.53±5.20VS49.28±4.30（P=0.035）;Hospitally and6months follow-upreviewed LVEF comparison was49.96%±9.76%VS52.09%±5.68%（P=0.045）.The differences were statistically significant.Collateral circulation groups: LVDD in hospital and at the time of6months follow-up was51.30±6.22VS47.04±3.66（P=0.027）; LVEF in hospital and6months follow-upLVEF was compared to47.91%±10.73%VS55.49%±5.04%（P<0.001）. Thedifferences were statistically significant.Conclusion:For the patients of acute ST segment elevation anterior myocardialinfarction treated by emergency PCI:1. Hypertension, LDL may have adverse effect on the formation ofcollateral circulation;2. Patients who have angina before infarction are more likely to havecollateral circulation;3.Collateral circulation can reduce myocardial infarct area, inhibitmyocardial remodeling,improve cardiac function, reduce the incidence ofserious cardiovascular adverse events and complications. |
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