| Objective To investigate the clinical data and risk factors of ventricular aneurysm complications in patients with acute anterior myocardial infarction,to provide a basis for early identification of high risk patients and to assess the risk factors for early assessment of LVA in AMI patients.Methods Case-control study.A total of 2602 patients with acute anterior myocardial infarction and coronary angiography were enrolled in the Department of General Hospital of Ningxia Medical University from January 2010 to October 2016.Of these,106 cases were complicated with ventricular aneurysm,compliance with the inclusion criteria of 85 cases for the case group.Randomly selected the same time period admission,according to age,gender match without ventricular aneurysm formation of acute anterior myocardial infarction 170 cases as the control group.To summarize and analyze the related factors of aneurysm formation.The conditional Logistic regression analysis was used to analyze the independent risk factors of acute anterior wall myocardial infarction complicated with ventricular aneurysm.Results In this study,85 patients with acute anterior myocardial infarction complicated with ventricular aneurysm were included,including 57 males(33.3%)and 28 females(33.3%),mean age(62.45±11.89)years;170 patients with acute anterior myocardial infarction among the patients,there were 114 males(66.7%)and 56 females(66.7%)with an average age of(62.44 ± 11.86)years.(1)There were no significant differences in age,sex,ethnicity,hypertension,diabetes mellitus,hyperlipidemia,old myocardial infarction,PCI history,family history of coronary heart disease,smoking history and stroke in the two groups(P>0.05).Clinical baseline data are basically the same.(2)The incidence of systolic blood pressure,sinus tachycardia,malignant arrhythmia and STEMI were higher in patients with LVA than in non-LVA group,while the incidence of angina pectoris in LVA group was lower than that in non-LVA group(all P <0.05).(3)The levels of NT-proBNP,WBC,PLT,UREA and UA in LVA group were higher than those in non-LVA group(all P <0.05).(4)LVA group LVEF,FS levels were lower than non-LVA group(all P <0.05),LVEDD and LVESD in LVA group were higher than those in non-LVA group(P <0.001).The incidence of left ventricular thrombosis in LVA group was higher than that in non-LVA group(P <0.001).(5)The KillipIII and KillipIV level of cardiac function in LVA group were higher than those in non-LVA group(all P <0.05).(6)Group LVA underwent emergency PCI and the establishment of collateral circulation was higher than that in non-LVA group(all P <0.05);and group LVA single vessel lesion,lesion of vascular occlusion or subtotal occlusion were higher than the non-LVA group(all P <0.05).(7)At the time of admission,systolic blood pressure increased,KillipIII / IV grade,STEMI,single vessel disease,complete or complete occlusion of the lesion is an independent risk factor of LVA event,the OR values are: 5.113,13.008,12.076,6.025,7.296(all P <0.05).The ambulatory angina pectoris,emergency PCI,collateral circulation establishment is the protective factor of LVA event,OR values are: 0.196,0.071,0.151(all P <0.05).Conclusion The incidence of ventricular aneurysm formation was higher in patients with STEMI.NT-proBNP is not only a marker of myocardial necrosis and cardiac function,but also has a strong effect on the formation of LVA.The increase in systolic blood pressure at admission,KillipIII / IV grade,STEMI,single vessel disease,complete or secondary occlusion of the infarct is an independent risk factor for LVA after acute anterior myocardial infarction. |
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