| Objective:This study analyzes clinical data of the patients with acute myocardial infarction(AMI). Then it explores the factors of the formation of coronary collateral circulation and the effect of collateral circulation on the myocardial infarction patients who have experienced percutaneous coronary intervention(PCI).Methods:This study collected the cases of 142 patients who experienced the first AMI and then were treated in the Medical Department of Taiyuan Central Hospital from January 2013 to June 2014. All patients received PCI within 1d after their first paroxysm of AMI, among which male subjects are 108 and female 34. Their ages are from 35 to 75, with the average age 58±12.6. According to the result of coronarography, the patients are divided into the group of good collateral circulation(good group: level 2 and level 3 in collateral circulation) and the group of poor collateral circulation(level 0 and level 1 in collateral circulation) in terms of Rentrop’s collateral circulation grades. The study analyzes clinical data which might affect the establishment of collateral circulation in the two groups,including general data, the risk factors of coronary heart disease, blood biochemical examination, and coronarography, and hospital stays, bad cardiovascular conditions and the incidence of complication after the operation of PCI. Then it compares the differences between the two groups. All data are tested by the SPSS 17.0 software packages. P<0.05 shows there is significant difference.Results:1. The two groups have no significant difference(P>0.05)in age, sex, the history of smoking, blood lipid level, the distribution of pathological change of blood vessel [left anterior descending artery(LAD), left circumflex artery(LCX) and right coronary artery(RCA)].2. The morbidity of hypertension of the two groups is 60.4% VS 44.9%(P=0.043),that of diabetes mellitus 32.1% VS 60.7%(P=0.028), the rate of the course of angina before myocardial infarction 52.8% VS 34.8%(P=0.035). So there is significant difference in these data. Observing the numbers of pathologic change in coronary artery, we find the rate of triple vessel disease in poor group is markedly lower than that in good group, while the rate of single vessel disease in good group is evidently higher than that in good group(Both are P<0.05). The differences are significant in statistics.3. Univariate analysis between the groups was statistically significant when factors affecting the formation of collateral circulation Multivariate regression analysis Logisitic,find that diabetes mellitus(OR=0.22,P<0.05), the course of angina before myocardial infarction, the number of coronary artery lesion are independent effect factors for the formation of collateral circulation. The latter two are favorable factors for the patients to form CCC, while diabetes mellitus is the adverse factor to form collateral circulation.4. The two groups PCI postoperative LVEF 51.12%±7.12% VS 47.73%±6.91%,(P<0.05),postoperative hospital stays7.13±1.628 VS 8.44±2.074,(P<0.05),the rate of adverse events of cardiovascular disease and complication have significant difference20.8% VS 40.4%,(P<0.05).Conclusions:1. The age, sex, the history of smoking, blood lipid level, hypertension, and the distribution of pathological change of blood vessel [left anterior descending artery(LAD),left circumflex artery(LCX) and right coronary artery(RCA)] have no significant influence on Coronary collateral circulation.2. The course of angina before myocardial infarction and the number of coronary artery lesion are favorable factors for the patients to form good collateral circulation, while diabetes mellitus is the adverse factor for the formation of collateral circulation.3. Triple vessel disease is much easier than double and single vessel disease to form good collateral circulation.4. In patients with acute myocardial infarction, coronary collateral circulation can reduce myocardial necrosis in compensation, the protection of heart function, reduce MACE and the incidence of complications, improve the short-term curative effect after PCI. |
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