Study On The Influencing Factors Of Heart Failure That Occurs After PCI In Patients With The First Acute Myocardial Infarction

Objective: In this study,the clinical data of selected patients and coronary angiography data were analyzed to study the influencing factors of heart failure(HFpEF)with preserved ejection fraction after percutaneous coronary intervention(PCI)in patients with first acute myocardial infarction(AMI),and evaluate its predictive value.Methods:This study is a retrospective cohort study,which selects 155 patients with preserved left ventricular systolic function who underwent emergency PCI treatment in the Department of Cardiology of the Second Affiliated Hospital of Xinjiang Medical University from December 2020 to December 2022,and were diagnosed with AMI for the first time,according to whether the patients developed heart failure after coronary revascularization,the first group was the heart failure group(n=45 cases)and the second group was the non-heart failure group(n=110 cases).The general clinical data,laboratory examination indicators,echocardiography results,and coronary angiography data of the selected patients during hospitalization were retrospectively collected,and the indicators with statistical differences were used as independent variables,HFpEF was used as the dependent variable for univariate logistic regression analysis,and then after further multivariate logistic regression analysis,the risk factors related to heart failure with left ventricular ejection fraction preserved were screened out,and statistically significant indicators screened out according to the above screened indicators.Draw receiver operator characteristic ROC curves to determine the predictive value of risk factors.Results:The155 patients were divided into two groups,the first group was heart failure and the second group was non-heart failure.(1)The proportion of men,age,diabetes history,smoking history and other factors related to general clinical basic data in the heart failure group and non-heart failure group were not significantly different(P>0.05);The proportion of patients with hypertension in the heart failure group was higher than in the non-heart failure group(P<0.05).(2)The results of laboratory indicators of the two groups were not statistically significant(P>0.05)compared with central granulocyte count(NEUT),serum creatinine(SCR),uric acid(UA),total cholesterol(TC),potassium ion(K+),triglycerides(TG),low-density lipoprotein(LDL-C),and high-density lipoprotein(HDL-C);The values of hypersensitive C-reactive protein(hs-CRP),sodium ion(Na+),and amino-terminal cerebral natriuretic peptide precursor(NT-proBNP)in the heart failure group were higher than those in the non-heart failure group,and the difference was statistically significant(P<0.05).(3)The proportion of infarcts in the left main trunk(LM),left circumflex branch(LCX)and right coronary artery(RCA)of infarction-related arteries in the two groups was not statistically significant(P>0.05).The proportion of patients with left anterior descending branch(LAD)infarction in the heart failure group was greater than that in the non-heart failure group,and the blood circulation time in the heart failure group was also greater than that in the non-heart failure group,and the difference was statistically significant(P<0.05).(4)The results of multivariate logistic regression analysis showed that the history of hypertension(OR=5.331,95% CI1.823-15.590 P=0.002),NT-proBNP(OR=1.002,95% CI 0.662-1.022,P<0.001),the number of diseased vascular branches(OR=2.830,95% CI 1.452-5.519,P=0.002)and revascularization time(OR= 1.287,95% CI 1.040-1.594,P=0.02)were independent influencing factors(P<0.05)of HFpEF after PCI in patients with first-onset AMI.(5)The data after plotting the ROC curve showed that the areas under the curve of HFpEF after PCI in patients with hypertension,NT-proBNP,diseased vascular branches,and revascularization recanalization time predicted were 0.733,0.886,0.793 and 0.807,respectively.Conclusion: 1.Patients with the first acute myocardial infarction with preserved ejection fraction after PCI have a poor prognosis,among which hypertension,diseased vascular branches,NT-proBNP,and revascularization time are the influencing factors of heart failure with preserved ejection fraction.2.NT-proBNP has predictive value for heart failure with preserved ejection fraction after PCI in the first acute myocardial infarction.