Analysis On Correlative Factors For Occurrence Of Hypotension During Infarct-related Arteries Revascularized Instantly By PCI For Acute Myocardial Infarction

Objective To explore the risk and protective factors for occurrence of Hypotension during infarct-related arteries revascularized instantly by PCI for acute myocardial infarction. Methods All 84 selected hospitalized patients were in the line with the diagnostic criteria of Abstract Coronary Atherosclerotic Heart Disease in WHO. All the patients were fit to receive the direct PCI.The process of PCI was standard.The descending of blood press was judged by infarct-related arteries revascularized instantly in PCI if the systolic pressure≤12.0kPa(90mmHg) or the high base systolic pressure/ diastolic pressure≥20mmHg. Monovariate logistic regression was used to identify independent relative factors among 16 clinical and angiographic factors for occurrence of Hypotension,Then Monovariate logistic regression was be used to analysis the statistical significance factors.Results During primary percutaneous coronary intervention for acute myocardial infarction, hypotension were 61(72.62%)cases, Right coronary artery was 50 cases, Left anterior descending Left and circumflex coronary artery was 11 cases.Infarct-related arteries (IRA) were successfully revascularized in 2～26h. Logistic regression shows The eld( p=0.107),Sexuality(p=0.885),Hypertension(p=0.964),Diabete(p=0.594),Smoking(p=0.116),kidney disfunction (p=0.703),Hyperlipemia (p=0.237),blood flow≤TIMI1级(p=0.023),Q wave infarction(p=0.566),Onset time≤6小时(p=0.039),With cardiac rhythm (p=0.067),Right coronary artery infarction (p=0.004),CTFC>28,multivessel lesion (p=0.011),Preoperative hypertension(p=0.062),angina pectoris before infarction (p=0.019).Multivariate logistic regression analysis showed that independent risk factors for hypotension were Right coronary artery infarction(p=0.012),With cardiac rhythm (p=0.050) ,the time intervals from AMI onset to IRA reflow≤6 h(P= 0.014),blood flow≤TIMI1 Grade(p=0.051)and CTFC >28(P=0.047) and multivessel lesions(P=0.061).Pre-infarction angina was found to be an independent protective factor(P=0.025).Conclusions Short time intervals from AMI onset to IRA revascularization, inferior wall infarction location,CTFC>28,multivessel lesions may promote the occurrence of hypotension during primary PCI, whereas pre-infarction angina may be a cardio-protective.