Clinical Features Of Advanced Age Patients With Acute St-segment Elevation Myocardial Infarction And The Efficacy And Safety Analysis Of Primary PCI

Objective:To analyze the clinical features of advanced age patients with acute ST-segment elevation myocardial infarction,to investigate the efficacy and safety of primary PCI.Methods:A total of 160 STEMI patients were selected in the First Hospital of Jilin University Dept.2 discharged from 2018.1.1 to 2018.12.31,and they were divided into non-advanced age group(<70 years old,n=121,55.1±8.4)and advanced age group(?70 years old,n=39,76.8±4.7)according to the age.Patients in the two groups both received primary PCI,general clinical information,characteristics of coronary artery lesions,situation of intervention,postoperative conditions and adverse events in hospital were compared between the two groups.The evaluation criteria of coronary artery lesions were the presence of multi-vessel lesions,the location and degree of occlusion of "culprit" vessels,and the establishment of collateral circulation.The number of coronary stent implantation,the grade of postoperative TIMI,and no reflow were used as the evaluation criteria for revascularization reperfusion.Death in hospital,malignant arrhythmia and gastrointestinal bleeding were the evaluation criteria for adverse events in hospital.Result:1.The age,gender,smoking history,hypertension,serum d-dimer,hemoglobin concentration,Killip cardiac function ?? grade in admission and complications(cardiogenic shock and respiratory failure)of two groups were compared,the differences were statistically significant(P <0.05).2.The number of “culprit” vessel in advanced age group was more than that of non-advanced age group(P <0.05).The proportion of using vasopressor during the operation,no reflow and TIMI<3 grade after the intervention in advanced age group was also more than that of non-advanced age group(P <0.05).3.The incidence of paroxysmal atrial fibrillation,cardiac insufficiency and digestive tract hemorrhage after operation in advanced age group was more than that of non-advanced age group(P <0.05).The proportion of chest pain relieved,hospital mortality and the incidence of malignant arrhythmia in two groups were compared,the differences were not statistically significant(P >0.05).4.Binary logistic analysis showed that advanced age was an independent risk factor for cardiac insufficiency after primary PCI for STEMI patients.Advanced age and low serum hemoglobin concentration are independent risk factors for adverse events in hospital in STEMI patients.Conclusion:1.Advanced age was an independent risk factor for cardiac insufficiency after primary PCI for STEMI patients.Advanced age and low serum hemoglobin concentration are independent risk factors for adverse events in hospital in STEMI patients.2.Advanced patients with STMEI in the proportion of men,smoking and serum hemoglobin concentration with low proportion patients,but the proportion of patients with high blood pressure,Killip cardiac function ?? grade and concentration of D-dimer with higher level.3.Advanced patients with STEMI are more likely to have multiple coronary artery lesions,use vasopressor during the operation and appear the TIMI blood flow < grade 3 and no reflux after interventional therapy.4.Advanced patients with STEMI receiving primary PCI are more prone to occurring paroxysmal atrial fibrillation,cardiac insufficiency and gastrointestinal bleeding,showing a greater risk.However,the remission rate of chest pain,the incidence of malignant arrhythmia and the rate of death in hospital are similar to that of non-advanced age patients,showing a good short-term efficacy.