Analysis of risk factors for cardiac rupture after emergency PCI in patients with acute myocardial infarction
Objective To analyze the risk factors of cardiac rupture(CR)still occurrence after emer-gency percutaneous coronary intervention(PCI)in the patients with acute myocardial infarction(AMI).Methods The patients with AMI admitted and treated in this hospital from January 2017 to February 2021 were retrospectively analyzed.The patients with AMI who still developed CR after successful emergency PCI treatment were included in the CR group(n=27),and the patients with AMI who matched the gender,age,myocardial infarction location,acute ST-segment elevation myocardial infarction(STEMI)and successful e-mergency revascularization with the CR group according to the ratio of 1∶2,moreover without complicating CR served as the non-CR group(n=54).The gender,age,comorbidities,clinical indicators,laboratory indica-tors,drug use situation were collected for conducting the analysis.The univariate and multivariate logistic re-gression were used to analyze the risk factors of CR.Results There were no statistically significant differ-ences in the gender,age,comorbidities(hypertension,diabetes,hypercholesterolemia,old myocardial infarc-tion,old cerebral infarction,renal insufficiency,hyperuricemia)and myocardial infarction location between the two groups(P＞0.05).In the comorbidities,the incidence rate of atrial fibrillation in the CR group was higher than that in the non-CR group(25.9％vs.9.3％),and the difference was statistically significant(P＜0.05).The heart rate,serum creatinine,serum uric acid,N-terminal brain natriuretic peptide precursor(NT-proB-NP),cardiac troponin Ⅰ(cTnⅠ),proportion of no reflow in PCI,and the proportion of blood flow grade 3 in myocardial infarction thrombolysis test(TIMI)after PCI in the CR group were significantly higher than those in the non-CR group,while the proportions of systolic blood pressure,albumin,LVEF,use of β receptor block-ers and renin-angiotensin-aldosterone system(RAAS)inhibitors were lower than those in the non-CR group,and the differences were statistically significant(P＜0.05).Atrial fibrillation was an independent risk factor for CR(OR=3.06,95％CI:1.16-8.10,P＜0.05).High level of albumin(OR=0.93,95％CI:0.88-0.99,P＜0.05)and high level of LVEF(OR=0.92,95％CI:0.86-0.99,P＜0.05)were the independent protective factors for CR.Conclusion The occurrence of CR is correlated with multifactors,atrial fibrillation is an independent risk factor for CR,and the high levels of albumin and LVEF are the independent protective factors for CR.
万方数据
维普
