Correlation Research Of Serum Aldosterone Levels Before Percutaneous Coronary Intervention On Diseased Coronary Vessels And Short-term Clinical Prognosis In Patients With Acute ST Segment Elevation Myocardial Infarction

Objective To assess the value of serum aldosterone levels measure before percutaneous coronary intervention(PCI) in predicting multiple diseased coronary vessels and short-term clinical prognosis in patients with acute ST segment elevation myocardial infarction(STEMI).METHODS The study included 67 consecutive patients with acute STEMI undergoing PCI in CCU in the Second Hospital of Tianjin Medical University from March 2008 to October 2008. Blood samples were drawn through the femoral arterial sheath before cardiac catheterization with the patients in the supine position. Serum aldosterone levels were measured with a commercially available radioimmunoassay (RIA)kit. The patients history were collected the morbid change ratio of anterior descending branch, the length of morbid change and thrombus classification were noted down. All patients were tracked for subsequent cardiovascular events including cardiac death, myocardial infarction, heart failure,second PCI, coronary artery bypass and stroke during in-hospital and 30-day follow-ups. According to the serum aldosterone levels, the patients were divided into 2 groups, group A:serum aldosterone levels< 150μg/L, group B:serum aldosterone levels≥150μg/L. Quantity of diseased coronary vessels in the two groups of acute STEMI patients was compared, and multivariate Logistic regression analysis was used to judge whether the serum aldostrone levels can predict the short-term clinical prognosis in the patients with acute STEMI.RESULTS The patients with higher levels of serum aldosterone spent longer time of occurrence to PCI, and more multiple diseased coronary vessels compared than that with/lower aldosterone levels. And it had been found that there was an a increasing trend of cardiovascular serum events in the patients with higher serum aldosterone levels during follow ups. Logistic analysis showed that the diagnosis of diabetes (HR 2.934,95%CI 1.314 to 6.548, p=0.0086) and serum aldosterone level (HR 0.705,95%CI 0.573 to 0.868, p=0.0010) were independent prognostic factors after adjustment of all entered baseline variables.CONCLUSION The higher serum aldosterone level was associated with the increase of diseased coronary vessels and may be responsible for subsequent short-term cardiovascular events following PCI.