The Effects Of Different Treatments On Long-Term Prognosis Of Non-ST-Segment Elevation Myocardial Infarction With Multivessel Disease

Objectives The effects of different treatments on long-term prognosis were compared of non-ST-segment elevation myocardial infarction with multivessel disease.The different treatment methods include only dealing with culprit-only revascularization(COR)and onetime complete revascularization(CR).Methods A Total of 140 patients treated in hebei general hospital from 2016-01 to 2018-05 were enrolled.We excluded the patients who lost a phone interview.According to different treatments of non-ST-segment elevation myocardial infarction with multivessel disease,the patients were divided into 2 groups.One group was COR and the other group was CR.The number of COR was 95,and the CR was 35.Basic clinical information was collected.Results Patients with non–ST-segment elevation myocardial infarction(NSTEMI)with multivessel vessel disease(MVD).There were no statistical differences between the two groups in biochemical indices and echocardiography indices in 3 months.Compared with on admission,in 3 months had decreased LVESD[33.00(29.00,36.00)mm vs 30.00(28.00,35.00)mm,P=0.026],elevated LVEF[59.00%(53.00%,65.00%)vs 62.00%(56.00%,67.00%),P=0.022]and increased FS[30.66±6.14 vs 32.48±6.05,P=0.041] in COR,which was a statistical difference,and decreased LVEDD[48.00(45.00,52.00)mm vs 47.00(44.00,51.00)mm,P=0.221],which was no statistical difference.However,compared with on admission,in 3 months had decreased LVESD[32.00(31.00,35.00)mm vs 31.00(29.00,35.00)mm,P=0.348],LVEDD[48.00(46.00,52.00)mm vs 47.00(46.00,52.00)mm,P=0.976],elevated LVEF[58.00%(51.00%,64.00%)vs 62.00%(58.00%,66.00%),P=0.119] and increased FS[31.00%(26.00%,35.00%)vs 33.00%(30.00%,36.00%),P=0.156] in CR.The average follow-up period was 11.25 months.At the primary end point events(all-cause death,recurrence of myocardial infarction,target vessel revascularization,angina hospitalization),we compared culprit-only revascularization with one-time complete revascularization(6.32% vs 8.57%,P=0.035).And there was a statistical difference between the two groups.In the secondary end point events(angina recurrent,bleeding,arrhythmia,heart failure hospitalization,stroke),we compared culprit-only revascularization with one-time complete revascularization(23.15% vs 48.58%,P=0.031).The difference between the two groups was still statistically significant.According to the principle of multivariate logistic regression analysis,we found that NSTEMI to balloon(B=0.005,OR=1.005,95%CI1.000-1.010,P=0.043)was a risk factor for the occurrence of primary end point with nonST-segment elevation myocardial infarction with multivessel disease.However,COR(B=-0.614,OR=0.541,95%CI 0.297-0.986,P=0.045)was a protective factor for the secondary end point,reducing the occurrence of the secondary end point.Conclusions 1 COR strategy is an ideal strategy to improve the long-term prognosis of NSTEMI patients with multivessel disease2 COR can improve cardiac function in patients with NSTEMI with multivessel disease.3 NSTEMI to balloon was a risk factor for NSTEMI with multivessel disease in primary end point.4 COR was a protective factor for NSTEMI with multivessel disease in secondary endpoint events,improving the secondary endpoint events.Table11;Reference 159...