Studying Risk Factors And Clinical Outcomes In Hospital With PCI-related Myocardial Infarction

Objectives: To assess risk factors and clinical outcomes in hos- pital with PCI-related myocardial infarctionMethods: We performed a retrospective analysis on 145 PCI cases (from July in 2009 to March in 2010)patients with coronary heart disease who had elective stent implantation the Fujian Provincial Hospital ( normal cTn I pre-PCI). Patients were divided into two groups in terms of lev- el of cTnI in 24h after PCI : the cTnI-increased group(56 cases cTnI≥0.3ng/ml)and the cTnI-normal group (89 cases cTnI<0.3ng/ml),We investigated the baseline clinical, laboratorial , angiographic and proce- dural data and clinical outcomes in hospital.Results: Baseline clinical characteristics were similar between the incre- ased and the normal cTnI groups. There were significant diffrence in oral statins over 3days,hs-CRP,LVEF, creatinine in statistics(p<0.05). There were more oral statins over 3days in the cTnI- normal group(91% vs. 57.1%), higher hs-CRP in the cTnI increased group(6.08±7.82vs. 2.78±2.94).A univariate analysis revealed that patients with TnI-increased gro- up had significantly more multivessel (39.2% vs. 19.1%,P=0 .000) and multilesion interventions (83.9% vs. 34.8%, P=0.000). The lesions were longer , more often angulated and involving bifurcations, more diffuse vascular and more complex(type C) in the TnI-increased group. Number of stents was higher in the TnI-increased group, and more inflation times in advance(>3 times) or longer inflation times (>20 s) or higher inflation pressures (>10 atm) were used more often in the TnI-increased group. After multivariable analysis, independent predictors of elevated TnI after PCI included hs-CRP(odds rate [OR] 10.68,95% confidence interval [CI]3.91-26.69,p=0.000)total inflation times(>20 s)(OR3.85,95% CI1.31-11.34,p=0.014),diffuse lesion(OR3.98,95%CI1.43-11.04,p=0.008)and oral statins over 3days (OR0.119,95%CI0.035-0.408,p=0.001).Incidence of MACE in cTnI-increased group was higher than in cTnI-normal group (1.79%vs.0%),but there was no significant differ- ence in two groups (p=1.000).Conclusions: 1.The incidence of PCI-related myocardial infarction is 38.6%. 2. PCI- related myocardial infarction is more likely to take place after intervention on higher hs-CRP,longer inflation sum times ,diffuse lesion .3. Statins use is a protecting factor,especially oral statins over 3 days can prevent PCI-related myocardial infarction.4.PCI is one effective and secure way of revascularation with coronary artery disease.