Left Ventricular Aneurysm Formation Multivariate Analysis After Q Wave Myocardial Infarction

This study was performed to determine the clinical and angio-graphic factors that ware priory predictors of LVA following Q wave myocardial infarction and so to provide a paradigm which may identify patients who were candidates for aneurysm formation.MethodsWe selected retrospective analysis to complete out Case - control study. Of the patients who underwent coronary angiography during the interval between 2000. 9 ~2003. 2 in our hospital,94 persons were found to have Q wave MI and LVA (aneurysm group) (78 men, 16 women, mean age 58.61±13.15 years). The clinical and the angio-graphic data of these patients were compared with those of 57 consecutive patients (46 men. 11 women, mean age 56.281±10.01 years) with previous Q wave MI and without LVA ( control group). The SPSSprogram ( version 11.0) was used to perform all statistical calculations. Data was evaluated by using the unpaired Student t - tests and chi - square tests. The variables were chosen for further multivariate modeling were significant at the P = 0.05 level. Multivariate modeling was performed using logistic regression analysis. The variables were age,sex,risk factors for CAD (family history,current smoking,serun cholesterol level, hypertension, deabetes mellitus) , number of diseased vessel, collateral status, and time between the MI and coronary angiog-raphy.Results(1)ARB or ACEI was a kind of singificance factors (the patients with aneurysm 52. 1% , the patients without aneurysm 70. 2% , P = 0.029). Angiographic examination revealed left anterior descending artery (LAD) (87.2%vs73.7% , P=0.0352)was higher, in the aneurysm group compared to control group. (2)The others factors had not any singigicance between the two groups. (3)After adjustment for other clinical and angiographic variables by logistic regression analysis, ARB or ACEI ( OR=0.453 beta = -0.793 P=0.02895% CI=0.453-0. 920) remained the dependent protected determinant of LVA formation after MI. LAD(OR =2.514 beta =0.922 P =0.036 95% CI = 1.062 -5. 956) remained the independent risk determinants of LVA formation after MLConclusions(1) ARB or ACEI may be independent protected determinant inthe formation of LVA after anterior MI. (2)LAD may be an independent risk determinant in the formation of LVA after ML (3)The age , sex, Coronary heart disease risk factors (hypertension, diabetes melli-tus, hypercholesterolemia, smoking and family history of CAD ) , absence of previous angina, coronary collateral vessels, thrombolytic therapy may be not found to be directly related to the aneurysm formation.