| BackgroundAcute myocardial infarction is a serious clinical type of coronary heart disease and its mortality rate is still rising.Primary percutaneous coronary intervention is the main strategy to reperfusion therapy of acute myocardial infarction.Ischemic J wave is a common change of electrocardiogram in acute myocardial infarction.In recent years,a number of studies have shown that the ischemic J wave is closely related to the malignant events such as ventricular tachycardia,ventricular fibrillation and sudden cardiac death after acute myocardial infarction.However,there are few studies on the electrocardiogram characteristics of ischemic J wave and the prognosis of acute myocardial infarction in China and there is still few evidence between the electrocardiogram characteristics of ischemic J wave and the prognosis of acute myocardial infarction.ObjectiveTo investigate the relationship between the electrocardiogram characteristics of ischemic J wave and the prognosis of acute myocardial infarction after primary percutaneous coronary intervention during hospitalization.Methods137 patients diagnosed with acute myocardial infarction in our hospital and treated with primary percutaneous coronary intervention(pPCI)between May 2017 and May 2018 were enrolled.Among them,110(80.3%)were males and 27(19.7%)were females.A detailed record of patients clinical data,including: name,gender,age,body mass index(obtained through the calculation of weight and height),smoking history,drinking history,history of hypertension,diabetes,dyslipidemia,blood uric acid level,peak value of CKMB,admitted to hospital for the first time blood sugar levels,total ischemia time,left ventricular ejection fraction and heart rate,the results of coronary angiography(infarct related blood vessels),electrocardiogram(including ischemic J wave and its shape,amplitude,distribution lead),The incidence of major adverse cardiovascular events(MACE)during hospitalization.According to the presence or absence of ischemic J wave in electrocardiogram,the patients were divided into two groups:ischemic J wave group and non ischemic J wave group.Clinical data and incidence of major adverse cardiovascular events were compared between the two groups.To further explore the relationship between electrocardiogram characteristics of ischemic J wave and MACE,the ischemic J wave group was divided into MACE subgroup and non MACE subgroup.Statistical methods were used to compare electrocardiogram characteristics of ischemic J wave between the two subgroups.ResultsAmong 137 patients with acute myocardial infarction,46 patients were in the ischemic J wave group,accounting for 33.6% of all subjects studied.There were 10 cases of MACE in the ischemic J wave group,accounting for 21.7% of the patients in this group;There were 7 cases of MACE in the group without ischemic J wave,accounting for 7.7% in this group and there was a statistically significant difference in MACE incidence between the ischemic J wave group and the non ischemic wave group(21.7% vs 7.7%,P = 0.019).There was no statistical difference in the proportion of ischemic J wave notch pattern and slur pattern in MACE subgroup(27.3% vs 20%,P = 0.927).The mean amplitude of the ischemic J wave in the MACE subgroup was(0.423±0.229)mv and the mean amplitude of the ischemic J wave in the non MACE subgroup was(0.226±0.106)mv,which were statistically different(P = 0.025).There was no statistic difference between the distribution lead of ischemic J wave and MACE(P = 1.000).ConclusionIschemic J wave is associated with the occurrence of MACE during hospitalization after primary percutaneous coronary intervention for acute myocardial infarction patients;The increased amplitude of ischemic J wave may be an indicator to predict MACE in patients with acute myocardial infarction during hospitalization after primary percutaneous coronary intervention. |
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