Multivariate Analysis Of Ventricular Aneurysm In Patients With Post-Acute Myocardial Infarction

Objective: Medical history data,complications,coronary artery lesion,laboratory index,echocardiographic index and prognosis of VA(Ventricular Aneurysm)in patients with postacute myocardial infarction were analyzed retrospectively,to investigate its clinical features and risk factors,to explore its controllable risk factors,to propose intervention measures to provide information and evidence for reducing the incidence of VA and cardiovascular events.Methods: In this retrospective analysis,70 cases diagnosed with VA in patients with postacute myocardial infarction in department of cardiology of affiliated hospital of Zunyi medical college from January 2010 to September 2016 were included in the study group,and randomly 70 patients with AMI who were not associated with VA at the same time were selected as control.By retrospective analysis of medical history data,complications,coronary artery lesion,laboratory index,echocardiographic index and prognosis of VA in patients with post-acute myocardial infarction.Finally,all of the risk factors for VA in patients with post-acute myocardial infarction were quantitatively analyzed by a binary logistic regression model to find out the controllable risk factors of VA.Results:(1)In univariate analysis,age(the patients with aneurysm 68.01±11.081,the patients without aneurysm 56.93±10.772,P=0.000),smoking history(45.71% vs 68.57%,P=0.006),history of previous myocardial infarction(42.85% vs 8.57%,P = 0.000),history of stroke(32.28% vs 0.00%,P=0.000),heart failure(14.28% vs 0.00%,P=0.001),simple left heart failure(30.00% vs 8.57%,P = 0.001),LVEF decrease(90.00% vs 45.55%,P=0.000),concurrent stroke(30.00 vs 4.28%,P=0.000),all-cause mortality within 1 year outside hospital(10.00% vs 14.28%,P =0.000),occlusion of the left anterior descending branch(95.74%% vs 80.00%,P =0.016),APOB(0.8380±0.30044 vs 1.0127±.23991,P=0.000),elevated white bloodcell count(28.57 vs 45.71%,P = 0.000)were significant difference between the two groups in both ventricular aneurysm and non-aneurysm.(2)After multiple factor analysis by establishing Logistic regression model,age(OR = 1.072 b = 0.069 P = 0.005 95%CI = 1.021-1.125),history of previous myocardial infarction(OR=8.228 b=2.108 P=0.002 95%CI=2.120-31.931)?LVE F decrease(OR =6.911 b= 1.933 P= 0.007 95%CI =1.679-28.444)? concurrent stroke(OR=6.905 b=1.932 P=0.006 95%CI=1.747-27.294)were all independent risk factors of the ventricular aneurysm in AMI.Conclusion: Age ? history of previous myocardial infarction ? LVEF decrease ?concurrent stroke were all independent risk factors of the VA in patients with post-acute myocardial infarction.Clinical intervention to the risk factors should be carried out actively to reduce the clinical incidence of VA post post-acute myocardial infarction and improve the prognosis.