Analysis Of Relationship Between Clinical Features And Heart Failure In214Casess With Acute ST-segment Elevation Myocardial Infarction

Objective：To analyze clinical data of214hospitalized patients WITH acuteST-elevation Myocardial Infarction (STEMI) in retrospecte, discussthe correlationshiop between clinical features and heart failure.Methods:It was retrospectively analyzed that involve214acuteST-elevation myocardial infarction patients who were treated in JilinProvincial China-Japan union Hospital from January2013toDecember2013.Analysis of the patient’s age, sex, hospitalization,medical history, ECG changes, coronary angiography, laboratorytests, echocardiography related indicators and therapy situations inorder to find out what related to heart failure in STEMI patientsafter PCI.The214casess of STEMI patients were divided into heartfailure group (n=78) and non-heart failure group (n=136) basedon the Left ventricular ejection fraction, analysis two sets of data ona single factor, screening possible risk factors of heart failure.Thencollect related risk factors (P <0.05)into multivariate Logisticregression analysis to discovery independent risk factors for heartfailure in STEMI patients after PCI.Reasults:Divide214casess of STEMI patients into two group:78cases(36.4%) in heart failure group and136cases（63.6%）innon-heart failure group. Comparison of clinical material characteristics between two group, there are48cases (61.5%)oldpatients in heart failure group while56cases old patients (41.2%) innon-heart failure group, difference of age was statistically significant(P=0.004).The heart rate (84.0±16.1) and the systolic bloodpressure （144.7±34.7） of heart failure group is higher than（75.4±16.4）、（136.4±25.4）in non-heart failure group。13cases(16.7%) in heart failure group with Atrial fibrillation,8cases (5.9%) innon-heart failure group with Atrial fibrillation, it is tatisticallysignificant. Analysis Coronary arteries between heart failure groupand non-heart failure group, STEMI patients with Multivesseldisease has more probability to be heart failure（P=0.00）. Furtherdivided214STEMI into Left anterior descending arterydisease(126cases58.9%) and not Left anterior descending arterydisease(88cases41.1%), primary artery difference was statisticallysignificant (P <0.05)。The analysis of different patency time betweenthe heart failure group and non-heart failure group with STEMI inhospital confirm that the earlier patency of the artery, the less thepossibility of heart failure.The STEMI patients hospitalizedlaboratory parameters were analyzed, the results suggest that cTNI(27.16±28.89)and BNP (10221.43±6269.00) of heart failurepatients with were higher than those of non-heart failure group cTNI(4.75±9.69), BNP (2018.87±1752.81), both have significantdifference (P <0.05). Analyze of treatment strategies STEMIpatients between heart failure group and non-heart failure group show that the use of ACEI and trimetazidine was significantly higherin on-heart failure group than in heart failure group.Analysis ofSTEMI hospitalized patients in multiple factors Logistic regressionways showed that: in214casess of STEMI,according to analyzingthe heart failure group and non-heart failure group in single-factorstatistic ways, we made the conclusions STEMI heart failure hascorrelationship with the age、heart rate、systolic blood pressure、Atrial fibrillation、Coronary arteries、Left anterior descending arterydisease、different patency time、BNP、cTNI、use of ACEI andtrimetazidine。Further reaserch about the possible associated riskfactors in more factors Logistic regression analysis showed that aSTEMI patient with Left anterior descending artery diseaseand withhigher cTNI is more likely to be heart failure.And the use oftrimetazidine will induce the possibilityConclusion：1. The risk of STEMI patients with heart failure significantlyincreased with age, heart rate, high systolic blood pressure,Atrial fibrillation、high BNP、high cTNI。2. STEMI patients with Multivessel disease and Left anteriordescending artery disease has more probability to be heartfailure。3. The use of trimetazidine and ACEI will induce the possibility ofheart failure in STEMI patients with conventional treatment after PCI.4. Left anterior descending artery diseaseand and higher cTNIwere independent danger factor for STEMI patients heartfailure.And the use of trimetazidine will Indeed induce thepossibility to be heart failure.