The Prognosis Value And Correlation Factors Of Imperfect Single-lead ST-segment Resolution In Patients With Acute Myocardial Infarction After Emergent Percutaneous Coronary Intervention

Objective:To rank high risk patients of ST-segment elevation myo- cardial infarction(STEMI)after emergent PCI early, and provide clinic evidence for taking appropriate interventions to reduce the occurrence of major adverse cardiac events(MACE) and improving the prognosis in those patients, We explore the prognostic value and correlation factors of imperfect single-lead ST-segment resolution(single-lead STR) in patients with STEMI early after emergent PCI.Methods:A total of 174 ptients with STEMI who underwent emergent PCI were analyzed retrospectively.Electrocardiograms were recorded before PCI and one hour after PCI.According to the grade of single-lead ST- segment resolution,the cases were divided into imperfect ST-segment reso- lution group:single-lead ST-segment resolution<50% and perfect ST-seg- ment resolution group:single-lead ST-segment resolution≥50%. The clinical data, angiographic images,and MACE in the two groups were compared, and clinical characteristics and the differences of MACE were analysised. Correlation factors associated with imperfect STR were analyzed by logistic regression method.Results:1.Although TIMI gradeⅢflow was achived after emergent PCI, imperfect STR was shown in 40.23 percent of the STEMI patients2.Factors such as white blood cell count, neutrophil–lymphocyte ratio (N/L),anterior myocardial infarction and Attack-to-Balloon Time in the imperfect STR group are significantly higher than these in perfect STR group, while the pre-infarction angina and inferior myocardial infarction in the imperfect STR group are significantly lower than these in perfect STR group.(P<0.05).3.There are no significant difference in the scope of affection and"criminals"vascular between perfect STR group and imperfect STR group.4.As compared with the patients with the perfect STR, those with imperfect STR were associated with lower left ventricular ejection fraction, longer hospital days, higher ventricular wall motion abnormality index, and a greater incidence of MACE(P<0.05).5.Logistic regression analyses showed that anterior myocardial infarction,Attack-to-Balloon Time and white blood cell count were indepen- dent predictors of imperfect STR.Imperfect STR was not happened easily in the patients with pre-infarction angina.Conclusions:1.Imperfect single-lead STR may be a indicator of predicting the early MACE in STEMI patients.2.Anterior myocardial infarction, Attack-to-Balloon Time and white blood cell count were independent risk factors for imperfect STR. The imperfect STR were not easily happened in the patients with pre-infarction angina.