Clinical characteristics of patients with ST-segment elevation acute myocardial infarction complicated with ventricular fibrillation
Objective To explore the clinical characteristics of patients with ST-segment elevation acute myocardial infarction complicated with ventricular fibrillation.Methods 276 cases of ST-segment elevation acute myocardial infarction patients were selected as the study subjects.All patients were treated with emergency percutaneous coronary intervention(PCI),and they were divided into a ventricular fibrillation group(50 cases)and a non-ventricular fibrillation group(226 cases)according to whether they had ventricular fibrillation before PCI vessel patency.The clinical data of the two groups were compared,including myocardial infarction location and coronary artery lesion,cardiac function index and cardiac damage index,prognosis.Results There were no significant differences in gender and diastolic blood pressure on admission between the ventricular fibrillation group and non-ventricular fibrillation group(P>0.05).In the ventricular fibrillation group,the age of patients was(69.58±11.02)years old,72.00%of patients with hypertension,36.00%of patients with diabetes mellitus,34.00%of patients with heart rate of(89.36±5.28)beats/min on admission,34.00%of patients with Killip grade>Ⅱ,20.00%of patients with atrial fibrillation,and the systolic blood pressure was(135.26±25.13)mm Hg(1 mm Hg=0.133 kPa),which were significantly higher than(59.03±13.25)years old,50.44%,22.12%,(78.63±8.23)beats/min,19.03%,2.65%,and(120.36±14.25)mm Hg in the non-ventricular fibrillation group(P<0.05).The percentage of anterior myocardial infarction in the ventricular fibrillation group was 74.00%,which was significantly higher than 40.71%in the non-ventricular fibrillation group;and the percentage of inferior myocardial infarction was 18.00%,which was significantly lower than 38.05%in the non-ventricular fibrillation group(P<0.05).The percentage of coronary lesions in left anterior descending branch in the ventricular fibrillation group was 62.00%,which was significantly higher than 42.04%in the non-ventricular fibrillation group(P<0.05).The number of coronary lesions with 3 branches in the ventricular fibrillation group was 24.00%,which was significantly higher than 5.75%in the non-ventricular fibrillation group(P<0.05).Comparison of left ventricular end-systolic diameter between the two groups showed no statistically significant difference(P>0.05).In ventricular fibrillation group,the peak value of creatine kinase isoenzyme(CK-MB)was(356.36±25.13)U/L,the plasma N-terminal pro-brain natriuretic peptide(NT-proBNP)was(1856.56±425.26)ng/L,and serum troponin I(cTnI)was(15.26±1.25)ng/L,which were significantly higher than(275.13±31.25)U/L,(958.37±142.01)ng/L,and(7.45±1.76)ng/L in the non-ventricular fibrillation group;the left ventricular end-diastolic diameter was(39.02±4.25)mm and the left atrial diameter was(44.07±5.69)mm,which were significantly larger than(31.25±5.13)and(35.29±7.24)mm in the non-ventricular fibrillation group;the left ventricular ejection fraction was(46.45±9.68)%and the ratio of peak mitral flow velocity in early diastole(E)to peak mitral flow velocity in late diastole(A)(E/A)was(0.89±0.17),which were significantly lower than(54.02±11.52)%and(1.23±0.24)in the non-ventricular fibrillation group(P<0.05).The prognosis of patients was followed up until May 2023.The mortality rate in the ventricular fibrillation group was 16.00%(8/50),which was significantly higher than 3.54%(8/226)in the non-ventricular fibrillation group(χ2=11.640,P<0.05).Conclusion Patients with ST-segment elevation acute myocardial infarction complicated with ventricular fibrillation have certain clinical characteristics,which should be identified in time and intervened as early as possible to improve the prognosis of patients.
万方数据
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