| Objective: To study the clinical features and prognosis of the patients with STEMI complicated by CS, who underwent percutaneus coronary interventions,when we analysis the patients with STEMI complicated or not by CS.Methods:A retrospective registry included data of 224 hospitalized patients with STEMI who underwent immediate percutaneus coronary interventions and admitted to the First Affiliated Hospital of Soochow University from January 2007 to December 2009. Among this subpopulation, 31 (13.8%) patients were with STEMI complicated with CS and 193 (86.2%) patients were with STEMI without complications from CS. The mean age was 61.2±12.8 years old.Patients included 185 males and 39 females.Through comparing the clinical characteristics, angiographic picture and parameters of the in-hospital period of the 2 groups,we analyzed risk factors of patients with STEMI complicated by CS,using binary logistic regression analysis.Followed up the patients who survived and draw the survival curve by using Kaplan-Meier method.Cox proportional hazards regression modeling was used for multivariable modeling of risk factors for the long-term prognosis.Results:1.Significant difference were found between the CS group and non-CS group in age(67.0±11.5vs.60.3±12.8, p=0.007) and male composition(67.7%vs.85%, p=0.023). It is worth to know that female is more likely to get CS compared to the non-CS group. There were no significant differences between the 2 groups with regard to infarction pain time(from onset to admission),anterior wall infarction, risk factors and past heart and cerebral diseases(p>0.05).2. We can discover significant differences between the two groups with respect to angiographic:the TIMI 3 after PCI(74.2%vs.90.2%,p=0.018) and multivessel coronary disease(32.3%vs.16.6%,p=0.038). There were no significant differences between the 2 groups with respect to coronary artery responsible for infarction,baseline TIMI flow 0-1(p>0.05).3.There were significant differences between the two groups with respect to the parameters of the in-hospital period:the proportion of high BFS(58.1%vs.31.6% ,p=0.008),LVEF (0.35±0.91vs.0.43±0.11,p=0.006)and in-hospital mortality (25.8%vs. 2.6%,p<0.001).But there were no significant differences about complications and the level of CK-MB(p>0.05).4.By using binary logistic regression analysis,independent factors affecting the risk of patients with STEMI complicating by CS were age,sex,BFS,LVEF and multivessel coronary disease.5. The mean follow-up time of 211 patients who did not died in hostital from 224 patients was 24.9±10.8 months.The 6-month survival rates of CS group and non-CS group were 67.7% and 95.3%,and the 1-year survival rates were 64.5% and 93.8%. It was shown in Cox proportional hazards regression modeling that CS ,age, anterior wall infarction,the TIMI flow after PCI were correlated with the long-term prognosis of the patients of STEMI.6. The level of LVEF(0.41±0.91 vs.0.30±0.82, p=0.04),in-hospital mortality (6.7% vs.43.8%, p=0.023) and one-year mortality(13.3%vs.56.3%, p=0.013) of patients with inferior wall infarction complicating CS were significant different from those ones who were non-inferior wall infarction.There were no significant differences between the two groups with respect to clinical characteristics, angiographic and in-hospital mortality between two groups(p>0.05).Conclusions:1.The characteristics of patients with STEMI complicated by CS were advanced age, female,higher BFS, multivessel coronary disease,lower TIMI grade after PCI and lower LVEF.2.The risk factors of the long-term mortality of patients with STEMI were CS,age, anterior wall infarction,the TIMI grade after PCI.3.With the progress of medical technology,the prognosis of patient with AMI coplicated by CS was better.The long-term mortality of patients with inferior wall infarction complicated by CS was better than those with non-inferior wall infarction complicated by CS. |
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