Relationship Between Admission Heart Rate And Prognosis Of Myocardial Infarction With Direct PCI Of Criminal Blood Vessels With Right Crown

Objective:Bradycardia often occurs in patients with right-heart coronary artery ST-segment elevation myocardial infarction,But is the heart rate related to this type of illness?It is not clear whether the angiography or clinical outcome of the population is poor.We tried to determine the admission heart rate(AHR)to the right coronary artery Prognostic significance of patients with lesions.Analysis of the relationship between admission heart rate and direct PCI-treated right coronary artery(RCA)for angiographic correlation and cardiovascular outcome in patients with criminal vascular disease,Provide good guidance for the treatment of patients with prognosis.Methods: 384 patients with ST-segment elevation myocardial infarction who under went percutaneous coronary intervention and who underwent right coronary artery disease from January 2015 to January 2019 were enrolled,Patients enrolled in patients with acute height atrioventricular block(AVB;Mobitz II,III and 2:1 AVB)。 Grouped according to the range of hospital heart rate(AHR<60,61-79,80-99 and ≥100 times/min)。First collect the clinical data of the selected patients,These include name,hospital number,age,gender,history of hypertension,diabetes,history of chronic kidney disease,history of previous myocardial infarction,history of atrial fibrillation,beta blockers,and calcium blockers。Whether you have heart failure at admission,whether you have cardiogenic shock,Heart rate,blood pressure,cardiac function Kilip grading,left ventricular ejection fraction。Collection of lesions,TIMI blood flow,TIMI perfusion,and thrombotic calcification by contrast。Then analyze the general clinical data of the selected patients,Assess the overall general condition of the selected patients.According to the heart rate of the patients when they were admitted to the hospital,they were divided into 4 groups,analysis of known clinical data between the four groups,analyze whether the heart rate of admission is related to the location of the right coronary lesion,the degree of thrombotic calcification,and the TIMI blood flow,collecting MACE events and mortality within 30 days,Followed up by phone or clinic for 1 year,comparing MACE events and mortality after 1 year.Result:The general clinical data analysis of the patients showed that patients with AHR≥100bpm had the highest left ventricular ejection fraction <40%,diabetes,and smoking in cardiogenic shock compared with other groups.Difference(P<0.05).In terms of age,gender,previous PCI history,history of coronary heart disease,history of myocardial infarction,history of renal insufficiency,history of atrial fibrillation or atrial flutter,beta blockers,and calcium channel blockers,There was no statistical difference between the two phases.After PCI with heart rate <60 beats/min,TIMI blood flow reached grade III and TIMI myocardial perfusion grade reached the highest proportion of grade 3,compared with other groups.In patients with tachycardia who had a heart rate of ≥100 beats/min,the ratio of TIMI blood flow grade III and TIMI myocardial perfusion grade 3 was the lowest after PCI treatment,and there was a difference between the groups.Patients with admitted heart rate(AHR ≥ 100 beats / min)had a higher incidence of severe calcification than all other AHR groups.There was no direct correlation between the lesions in each group and the heart rate of admission.Univariate COX analysis: RCA was the 30-day and 1-year primary clinical MACE event and mortality for patients with infarct-related vasculature,the lowest in the heart rate of 60-79 beats/min,and the heart rate ≥100 beats/min.Mortality and clinical MACE events were highest.The clinical MACE events and mortality rates of patients who were followed up for 1 year were the lowest in the group of heart rate 60-79 beats/min.As the heart rate increased,the risk of clinical MACE events and death increased.Using single factor COX regression analysis,grouping of heart rate levels was used as categorical variables.Different heart rate levels were risk factors for clinical MACE events and death [respectively:(RR=1.60,95% CI 1.06-2.39,P<0.05),(RR=1.86,95% CI 1.09-3.19 P<0.05),(RR=1.45,95% CI 1.10-1.92,P<0.05),(RR=1.65,95% CI 1.19-2.29,P<0.05)].Univariate COX analysis: RCA was the 30-day and 1-year primary clinical MACE event and mortality for patients with infarct-related vasculature,the lowest in the heart rate of 60-79 beats/min,and the heart rate ≥100 beats/min.Mortality and clinical MACE events were highest.The clinical MACE events and mortality rates of patients who were followed up for 1 year were the lowest in the group of heart rate 60-79 beats/min.As the heart rate increased,the risk of clinical MACE events and death increased.Using single factor COX regression analysis,grouping of heart rate levels was used as categorical variables.Different heart rate levels were risk factors for clinical MACE events and death [respectively:(RR=1.60,95% CI 1.06-2.39,P<0.05),(RR=1.86,95% CI 1.09-3.19 P<0.05),(RR=1.45,95% CI 1.10-1.92,P<0.05),(RR=1.65,95% CI 1.19-2.29,P<0.05)].Conclusion: 1.Admission heart rate is an independent risk factor for death and clinical MACE events in patients with acute myocardial infarction with right coronary artery as infarct-related vessels.2.Admission heart rate >100 beats / min,the highest risk of death and clinical MACE events,tachycardia at admission was associated with increased 1-year mortality and major adverse cardiac events.