The Prediction Of Major Cardiovascular Events In Patients With Acute Myocardial Infarction By Deceleration Of Heart Rate

Objective To study the predictive value of heart rate deceleration(DC)and heart rate deceleration runs(DRs)on the major cardiovascular events(MACE)in patients with acute myocardial infarction(AMI)Methods 106 AMI patients and 30 non(coronary atherosclerotic heart disease,CHD)patients were divided into AMI group and control group.All the patients were completed the general data and 24 hour dynamic electrocardiogram,compared the two groups of heart rate deceleration,heart rate deceleration runs risk stratification;At the same time,the related data of laboratory related examination,left ventricular ejection fraction(LVEF),coronary angiography,myocardial infarction,and treatment after admission were collected for AMI patients.The average follow-up of AMI patients was 12-18(13.6±1.7)months.The major cardiovascular events such as cardiogenic death,severe heart failure,malignant arrhythmia,and recurrent myocardial infarction were observed during the follow-up period,and the risk factors such as DC and DRs were analyzed according to whether MACE was divided into MACE group and non MACE group.Results: 1.There was no significant difference in general information and risk factors between.AMI group and control group(P<0.05),but DC and DRs in group AMI were significantly lower than those in control group(P<0.05).2.There was no significant difference in general condition,risk factors,laboratory examination and basic medication between MACE group and non MACE group(P<0.05).3.The proportion of patients with three lesions in group MACE was significantly higher than that in non MACE group(P<0.05),and LVEF in MACE patients was significantly lower than that in non MACE group(P<0.05).4.The proportion of high-risk patients with DC and DRs in group MACE was significantly higher than that in non MACE group(P<0.05)5.The proportion of cardiac death,severe heart failure,malignant arrhythmia,and recurrent myocardial infarction in the risk stratified and high risk group of DC,DRs and DC combined with DRs was higher than that in the low and middle risk groups,and the rate of cardiac death in the high-risk group was significantly higher than that in the low and middle risk group(P<0.05).6.The incidence of MACE in DC,DRs and DC combined with DRs risk stratification high-risk group was significantly higher than that in low and medium risk group7.DC combined DRs risk stratification is higher than that of DC(85.7% VS 64.3%)and DRs(85.7% VS 64.3%),Youden index is higher than DC(67.8% VS 57.8%)and DRs(67.8% VS 55.6%),while its specificity(84.8%)is lower than DC,DRs 84.8%VS 93.5%,84.8% VS91.3%;8.A multiple factor Logistic regression analysis suggested that the rate of heart rate deceleration and continuous heart rate deceleration risk,LVEF decrease,and three pathological changes were independent risk factors of MACE in the follow-up period of AMI patients(P<0.05).9.Cox multivariate regression analysis showed that the rate of heart rate deceleration and continuous heart rate deceleration was high,LVEF decreased,and the probability of MACE in the three cases of AMI patients increased significantly(P<0.05).Conclusions: 1.heart rate deceleration and heart rate deceleration decreased in patients with acute myocardial infarction.2.the rate of heart rate deceleration combined with continuous heart rate deceleration predicts that the sensitivity of AMI patients to MACE is higher than that of heart rate deceleration and continuous heart rate deceleration.3.the rate of MACE in AMI patients with high risk of heart rate deceleration and continuous heart rate deceleration was significantly higher during follow-up.