Factors associated with major adverse cardiovascular events after PCI in patients with acute myocardial infarction
Objective:To investigate the factors associated with the occurrence of major adverse cardiovascular events(MACE)after percutaneous coronary intervention(PCI)in patients with acute myocardial infarction(AMI)and their predictive value for patient mortality.Methods:A retrospective analysis was conducted on the clinical da-ta of 2 154 AMI patients who underwent PCI from December 2012 to December 2020.Patients were divided into the MACE group(410 cases)and the non-MACE group(1 744 cases)based on whether MACE occurred after sur-gery.The general data,laboratory blood test indicators,and heart function indicators of the two groups were compared.Results:In the MACE group,male proportion and follow-up duration were significantly lower,while age,heart rate,pulse,Killip classification,diabetes,coronary artery disease,angina,heart failure,post-dis-charge Betaloc treatment,peripheral artery disease,and mortality were all significantly higher,compared to those in the non-MACE group,with statistically significant differences(P＜0.05).In the MACE group,HbA1c,im-mediate blood glucose,urea,creatinine,and sodium levels were significantly higher,while total protein,albu-min,total bilirubin,calcium,potassium,total cholesterol,low-density lipoprotein cholesterol,high-sensitivity C-reactive protein,red blood cell count,hematocrit,and hemoglobin were significantly lower,compared to those in the non-MACE group,with statistically significant differences(P＜0.05).Also,in the MACE group end-diastolic dimension,end-systolic dimension,end-diastolic volume and end-systolic volume,were significantly higher,while ejection fraction was significantly lower compared to the non-MACE group,with statistically significant differ-ences(P＜0.05).Multivariate Cox regression analysis indicated that Killip classification(1),peripheral artery dis-ease,urea,hematocrit,and hemoglobin were independent risk factors for the occurrence of MACE(P＜0.05).With the extending of the follow-up duration,the incidence of MACE and survival rate both decreased.Conclu-sion:Cardiac function,peripheral artery disease,urea,hematocrit,and hemoglobin levels are independent risk factors for the occurrence of MACE.Targeted interventions can be made accordingly for AMI patients undergoing PCI in clinical practice.
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