Analysis Of Clinical Characteristics Of Patients With Spontaneous Reperfusion In ST-segment Elevated Myocardial Infarction

Objective : To investigate the clinical characteristics of ST-segment elevated myocardial infarction(STEMI)patients with spontaneous reperfusion(SR).Methods:Using retrospective study method,continuous collection since January 1,2018 to December 31,2019,shihezi university school of medicine in the first affiliated hospital diagnosed with STEMI and adept in 12 hours emergency coronary artery angiography(CAG)surgery patients,563 cases.The 563 included patients were divided into spontaneous reperfusion group and non-spontaneous reperfusion group according to whether the infarction-related artery was spontaneously reperfusion or not.The general data,blood routine indexes,biochemical indexes,myocardial injury markers,color doppler ultrasound indexes,coronary angiography indexes,and major adverse cardiovascular events(MACE)were analyzed and compared between the two groups.The above collected indexes were recorded into statistical software SPSS23.0 for statistical analysis.Results:(1)Spontaneous reperfusion rate was 16.70% in 563 STEMI patients.(2)The white blood cell count,neutrophil count,neutrophil/lymphocyte ratio(NLR)and monocyte/high density lipoprotein cholesterol ratio(MHR)of the STEMI spontaneous reperfusion group were all lower than those of the nonspontaneous reperfusion group,with statistically significant differences(P<0.05).Lymphocyte count,high density lipoprotein cholesterol and albumin in the STEMI spontaneous reperfusion group were significantly higher than those in the non-spontaneous reperfusion group(P<0.01).The number of patients with cardiac function Killip grade ?2 of the STEMI spontaneous reperfusion group was less than that of the nonspontaneous reperfusion group,and the difference was statistically significant(P<0.001).There was no significant difference between the two groups in other aspects.(3)There were no statistically significant differences between the STEMI spontaneous reperfusion group and the non-spontaneous reperfusion group in terms of duration of chest pain to coronary angiography,proportion of infarct-related arteries and number of diseased vessels(P > 0.05).The proportion of coronary stent implantation in the nonspontaneous reperfusion group was lager than that in the spontaneous reperfusion group,and the difference was statistically significant(P<0.01).(4)Echocardiography was performed in all STEMI patients after emergency coronary angiography(hospitalization of 6.40±1.52 days).The left ventricular ejection fraction(LVEF)of the spontaneous reperfusion group was higher than that of the non-spontaneous reperfusion group,and the difference was statistically significant(P<0.001).The left ventricular end diastolic dimension(LVEDD)of the spontaneous reperfusion group was smaller than that of the non-spontaneous reperfusion group,and the difference was statistically significant(P<0.05).The number of patients with diastolic dysfunction and segmental motor abnormality in the spontaneous reperfusion group was lower than that in the non-spontaneous reperfusion group,with statistically significant differences(P<0.01).(5)The number of patients in the STEMI spontaneous reperfusion group who had MACE events during hospital stay was less than that in the non-spontaneous reperfusion group,with a statistically significant difference(P<0.01).The proportion of severe heart failure,sustained ventricular tachycardia,ventricular fibrillation,recurrent myocardial infarction and death in the STEMI spontaneous reperfusion group were all lower than those in the non-spontaneous reperfusion group.(6)The indicators with statistically significant differences in unifactorial analysis were taken into the multivariate logistic regression model,and the results showed that the IRA spontaneous reperfusion of STEMI patients was independently correlated with neutrophil/lymphocyte ratio,monocyte/high density lipoprotein cholesterol ratio,albumin,and the proportion of patients with cardiac function of Killip grade ?2(P<0.01).Conclusion:1.IRA of STEMI patients without intravenous thrombolysis or other reperfusion treatment had a certain spontaneous reperfusion rate(16.70%).2.Changes in neutrophil/lymphocyte ratio,monocyte/high density lipoprotein cholesterol ratio,albumin,and Killip grading of cardiac function were associated with STEMI spontaneous reperfusion.3.Left ventricular function of STEMI patients with spontaneous reperfusion was superior to that of non-spontaneous reperfusion patients,and the patients with spontaneous reperfusion had fewer major cardiovascular adverse events during hospitalization.