Evaluation Of Prognostic Factors In Patients With Acute Anterior Myocardial Infarction After Emergency PCI

As economic development,social aging,accelerated urbanization and changes in people's lifestyles,the incidence of coronary heart disease?CHD?is increasing year by year in our country.Cardiovascular disease is the leading cause of death^[1].Among many types of coronary heart disease,acute myocardial infarction?acute myocardial infarction,AMI?is the most serious type.AMI is a coronary artery lesion based on the occurrence of plaque rupture,thrombosis,or coronary artery spasm,etc.It is one of the main causes of death in patients with cardiovascular disease that the arterial blood supply is sharply reduced or interrupted,which leads to sustained and severe acute ischemia of the corresponding myocardium and eventually leads to myocardial necrosis.According to ECG characteristics,AMI was divided into st-segment elevation myocardial infarction?STEMI?and non-st-segment elevation myocardial infarction?NSTEMI?.Patients with STEMI presented persistent and intense chest pain,which could not be completely relieved by rest and nitroglycerin administration.Meanwhile,the level of myocardial markers increased and the electrocardiogram dynamic changes.It is currently the best way to treat AMI for patients with STEMI,by intravenous thrombolysis or emergency percutaneous coronary intervention?PCI?,then opening criminal blood vessels and to ensure myocardial reperfusion.However,not all patients benefit from the early reopening of infarct-related vessels after the intervention of AMI.There are still some patients with myocardial level reperfusion malperfusion^[2].Previous studies^[3]showed that after the interventional treatment for AMI,the ST-segment resolution of ECG?ST-segment resolution,STR?was correlated with myocardial perfusion,electrocardiogram the elevated ST-segment fell back?ST-segment resolution,STR?associated with myocardial perfusion,Moreover,it is related to patients'near and long-term mortality,and independent of TIMI blood flow grading,so it can identify patients who benefit early,and it is a relatively simple and feasible clinical indicator.Anterior wall AMI is the most common type of AMI^[4].Because the infarct site is the main functional myocardium and the infarct area is large,patients with anterior wall AMI have a higher risk of death in hospital than those with other AMI sites.In addition,studies^[5]have shown that the majority of patients with anterior wall AMI who received emergency PCI were dyspeptic.Objective:This study retrospectively analyzed the risk factors affecting ST segment regression after emergency PCI in patients with AMI in the anterior wall,so as to identify high-risk patients early and take further treatment measures,and Provide valuable clinical guidance.Methods:Retrospective analysis was performed on 102 patients with AMI who underwent emergency PCI in department of cardiology,handan central hospital from January 2016 to December 2018.They were divided into two groups according to the STR pullbacks of the patients after PCI in 2h.STR?50%is control group,STR<50%is observation group.The general case data and medical history data,clinical symptoms,electrocardiogram characteristics,pre-operation laboratory examination and operation related conditions between the two groups were compared.The data were analyzed by SPSS22.0.Logistic regression analysis was used to find the factors affecting the ECG STR in 2 hours after the operation.P<0.05 is considered statistical significance.Results:A total of 102 patients were enrolled in the study.The univariate analysis showed that the observation group and the control group were in the following aspects:neutrophil count/lymphocyte count,platelet count,random blood glucose?GLU?,whether using thrombosis vascular and vascular lesions?left main lesion,single lesion,double branch lesions,three lesions?differences had statistical significance?P<0.05?.Logistic regression analysis showed that neutrophil count/lymphocyte count and the count of platelet are the factors affecting the electrocardio graphic STR within 2 hours after PCI?P<0.05?.Conclusion:Neutrophil count/lymphocyte count and the count of platelet are independent factors to estimate STR in patients with AW-AMI after emergency PCI.