The Analysis Of The Factors Affecting Short-term Effect In Patients With Acute Myocardial Infarction After Emergency PCI

Objective To analyze the clinical outcomes of emergency percutaneous coronary intervention (e-PCI) in acute myocardial infarction(AMI) during hospital and follow-up period, to analyze the related risk factors affecting the prognosis and cardiac events, and to explore the predictive value on these clinical factors to the prognosis and cardiac events.Thus to provide important information for the risk stratification of AMI patients.Methods The Case analysis was used. From May 1st of 2009 to March 1st of 2010, emergency PCI was successfully performed in cardiology department of our hospital on 42 cases with AMI. According to whether cardiac events happened,cases were divided into two groups. The clinical factors were compared between the two groups.Results1. Gender The Gender showed no significant difference between the two groups (P>0.05)2. Age The patients (older than 70 years old) in cardiac event group were more than the cardiac event-free group. The foregoing factor showed significant difference between the two groups (P<0. 05).3. Past history In past history of hypertension,Pre-diabetes and diabetes mellitus,angina pectoris and obsolete myocardial infarction, no significant difference were showed between the two groups(P>0.05).4. Personal history and family History In personal history(smoking,drinking) and family History (coronary heart disease),no significant difference were showed between the two groups (P>0.05).5.Time The symptom-to-balloon time in cardiac event group were longer than the cardiac event-free group. The foregoing factor showed significant difference (P<0. 05) between the two groups. Whereas, The symptom-to-balloon time and hospitalization showed no significant difference between the two groups(P>0. 05). 6.Lipid The levels of TG,TC,LDL-C and HDL-C showed no significant difference between the two groups(P> 0. 05).7. Clotting mechanism In fibrinogen ((Fbg), The cardiac event group were higher than the cardiac event-free group. The fibrinogen showed significant difference between the two groups(P<0.05).The prothrombin time (PT),part of the activated prothrombin time(APTT) showed no significant difference between the two groups(P> 0. 05).8.ECG(T-wave inversion) At 0.5h,1.0h,1.5h,2.0h,6h,12h,24h,T-wave inversion showed no significant difference between the two groups(P> 0. 05).9.Echocardiogram The left atrial end diastolic dimension of the cardiac event group is longer than the cardiac event-free group.The LAEDD showed significant difference between the two groups(P<0. 05).The left ventricular ejection fraction(LVEF),left ventricular end diastolic dimension(LVEDD),Right ventricular end diastolic dimension(RVEDD) and Left ventricular segmental movement (RWM) showed no significant difference between the two groups(P>0.05).10. Angiography and PCI The patients with angiography of multi-vessel lesion,the infarction related artery (IRA) in LAD have a higher risk of cardiac events(P<0.05).Conclusions1.Age is an important predictor of cardiac events in the short-term of follow-up. Elderly patients have a higher risk of cardiac events.2.Symptom-to-balloon time is an important predictor of cardiac events in the short-term of follow-up.Improving accessibility of health services to patients with AMI is essential in reducing poor outcomes.3.Multi-vessel coronary disease is an important predictor of cardiac events in the short-term of follow-up. Patients with infarct related artery in left anterior descending artery have more cardiac event than in right coronary artery.4. Fibrinogen is an important predictor of cardiac events in the short-term of follow-up.