Clinical Characteristics And In-hospital Prognosis Of STEMI Patients With Mild-moderate Chronic Renal Insufficiency

Objective:To explore the clinical feaures of acute ST segment elevation myocardial infarction hospitalized patients with different renal insufficiency, and analyze the influences of different renal insufficiency on prognosis in patients with acute ST segment elevation myocardial infarction. Methods:The patients hospitalized in the cardiology department in Bethune first hospital of Jilin University from January 1 to December 31 in 2015 were selected, all of whom met STEMI standards and accepted emergency surgeries and implanted stents. Their information was complete. Their clinical information, vital signs, auxiliary examinations, blood vessels, myocardial infarction area, coronary artery lesions, number of stents, drugs used in hospital and prognosis of hospitalization were compared. Results:1.There were statistically significant differences in sex, age, chronic myocardial infarction, high blood pressure, stroke and smoking(P<0.05) among the normal renal function group, the mild renal insufficiency group and the moderate renal insufficiency group.2.Myocardial infarction areas were compared among the three groups, and it was found that there were statistically significant differences in antetheca or anteroseptal wall and Inferior wall myocardial infarction(P<0.05). The proportion of inferior wall myocardial infarction gradually rised and there were statistically significant differences among the three groups(P<0.016).3.There were statistically significant differences in heart rate, fasting plasma glucose, hemoglobin, blood urea nitrogen, creatinine, hospitalization days when vital signs and auxiliary examinations of the three groups were compared(P<0.05).4.When coronary artery lesions and collateral circulation were compared among the three groups, it was found that there were statistically significant differences in single vascular lesion, double vascular lesions and three vascular lesions(P < 0.05).However, no statistically significant difference was found in left main lesion and collateral circulation formation(P>0.05). Through the binary Logistic regression analysis, it was found that e GFR was an independent risk factor in acute STEMI patients with three coronary artery lesions.5.When the criminal blood vessels were compared among the three groups, the proportion of RCA as the criminal blood vessel increased significantly with the renal function level worsening, and the differences were statistically significant(P<0.05).6. When the numbers of stents in emergency surgeries were compared, it could be found that there were no statistically significant differences(P>0.05).7.When the drugs uesd after the surgeries were compared, it was found that the usage of IIb/IIIa receptor antagonist reduced gradually, and there were statistically significant differences among the three groups.8.When the clinical prognosis during the hospitalization were compared, it was found that the proportion of ventricular tachycardia ventricular fibrillation, atrial fibrillation, mechanical complications, gastrointestinal bleeding,and heart failure increased, and there were statistically significant differences among the three groups(P <0.05). Through the binary Logistic regression analysis, it was found that e GFR was an independent risk factor in acute STEMI patients who suffered from heart failure later. Conclusions:1.Compared with acute STEMI patients who had normal renal function, the possibility suffering from heart failure in patients who had mild or moderate renal insufficiency was larger, and their prognosis was worse.2.Compared with acute STEMI patients who had normal renal function, the proportion suffering from three vascular lesions in patients who had mild or moderate renal insufficiency was higher.