| OBJECTIVE To observe the incidence and risk factors of PCI-related myocardial infarction in the First Affiliated Hospital of Guangxi Medical University,so as to provide some clinical reference for the prevention and treatment of PCI-related myocardial infarction.METHODS According to the condition of admission group,276 patients with normal c Tn I were treated with percutaneous coronary intervention(PCI).Based on the c Tn I level at the 48 hours after PCI,the patients were divided into three different groups: Group I(c Tn I normal group,c Tn I ≤ 0.033 ng/m L,n=167);Group II(PCI-related myocardial injury group,0.033 ng/m L<c Tn I ≤ 0.165ng/m L,n=51);Group III(PCI-related myocardial infarction group,c Tn I >0.165ng/m L,n=58).The general clinical data and blood biochemical values,characteristics of coronary angiography and the operation parameters were compared among three groups.Logistic regression analysis was used to detect the risk factors of PCI-related myocardial infarction.After 6-24 months follow-up,the incidence of MACE after PCI was compared.RESULTS 276 patients were selected in this study.There were 167 cases(60.50%)whose c Tn I level were in the normal range after PCI,51 cases (18.47%)whose c Tn I level exceeded the upper limit of normal but less than five times,and 58 cases(21.01%)whose c Tn I level were more than five times the upper limit of normal.The preoperative hs-CRP in group II and group III were significantly different from group I(1.21 ± 0.56 vs 2.22 ± 0.83 vs 3.66 ±1.39 mg/L,P <0.001),and c Tn I was positively associated with hs-CRP;the proportion of multivessel coronary artery disease(39.53% vs 64.71%vs75.86%,P <0.001)and lesion type C(47.90% vs 56.86%vs 74.14%,P <0.001)in group II and III was higher than that of in group I;The operation parameters of three groups of patients with PCI were compared: The results showed that there were significant differences among the group I and the group II and the group III in terms of the number of stent(1.14 ±0.35 vs 1.27 ±0.45 vs 1.55 ±0.56,P<0.001),the total stent length(30.16 ±14.27 vs 35.94±14.23 vs 38.68±17.10 mm,P = 0.042),numbers of balloons(2.03 ±0.52 vs 2.39±0.14 vs 3.12 ±1.18,P =0.002),and balloon expansion maximum pressure(13.62±4.46 vs 14.58 ±4.36 vs 15.67±3.18 atm,P = 0.042),and the difference among the three groups was statistically significant.Result of logistic regression analysis showed that hs-CRP,total stent length,multiple stent implantation and lesion type C were the risk factors for PCI-related myocardial infarction(OR 10.017,1.054,3.878,3.325;95% confidence interval 5.183 ~27.308,1.118 ~ 1.291,1.520 ~ 9.896,1.143 ~ 76.084;P<0.05).Following up patients for 6-24 months we found that 3 cases of MACE(2 cases of heart failure,1 cases of target vessel revascularization)patients in the group I,4 cases of MACE(1 cases of heart failure,1 cases of recurrent acute myocardial infarction,2 cases of target vessel revascularization)patients in the group II,2 cases of MACE(1 cases of heart failure,1 cases of recurrent acute myocardial infarction)patients in the group III,the incidence of three groups of patients with short MACE(1.80% vs 7.84%vs 3.45%,P =0.103),the difference was not statistically significant.CONCLUSIONS 1.The incidence of PCI-related myocardial injury was18.47% and the incidence of PCI-related myocardial infarction was 21.01%;2.Hs-CRP,total stent length,multiple stent implantation,lesion type C were the risk factors for PCI-related myocardial infarction;3.Following up patients for6-24 months we found that PCI-related myocardial infarction did not increase the incidence of MACE in patients. |
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