Analysis Of Clinical Features For Acute Left Ventricular Dysfunction In Patients Undergoing Primary PCI For Acute STEMI

Objective To investigate the clinical features of STEMI patients with acute left cardiac insufficiency occurs after the PCI.Methods Retrospectively analyzed 380 ST-elevation myocardial infarction patients who were treated in The First Affiliated Hospital of Dalian Medical University from January2013 to February 2015.The 380 cases of STEMI patients were divided into two grousp based on the killip classification method.The acute cardiac insufficiency group included80 cases and the control group included 300 cases.Compared the data of the two groups to select factors that may occur in acute cardiac insufficiency patients after STEMI.Then collected all related risk factors(P <0.05)into Logistic regression analysis and revealed the independent risk factors.Result Comparison of clinical material between two groups,the average age of patients in experiment group was 66.31±10.66 years while the average age of control group was61.38±11.83 years,P =0.001.There were 26 male patients in acute cardiac insufficiency group and 49 female patients in control group,p=0.001.31 diabetes patients in experiment group(38.8%)was higher than 68 diabetes patients(22.7%)in control group,P=0.004.50 hypertension patients in experiment group(62.5%)was higher than150 patients in control group(50%),P=0.047.The two groups in family history and smoke were of no significant difference(P > 0.05).The hs-Tn I median 211.92 ug/L in experiment group vs median 101.42 ug/L in control group,P < 0.001.The LVEF of patients with acute heart failure 45(36,54)was significantly lower than that of control patients LVEF 55(50,58),p<0.001.The median of BNP was 447.49 ug/L in experiment group vs median 146.18 ug/L in control group,P < 0.001.56 cases with the anterior descending branch in acute heart failure group was significantly higher than that in control group of 141 cases,P <0.001.5 cases(6.3%)died in the experientment group,whlie two cases(0.3%)died in control group,the difference was statistically significant(P=0.001).Collected all risk factors into Logistic regression and the result showed that female,diabetes,Lvef and BNP were the independent risk factor for the heart failure patients with STEMI after PCI.Conclusion Logistic regression analysis showed that female,bnp,diabetes and LVEF were the independent risk factors for acute left ventricular dysfunction in patients with STEMI after PCI.Logistic regression analysis showed that female,age,the anterior descending lesion and LVEF were the independent risk factors for STEMI patients with high peak of BNP.