The Analysis Of The Impact Of Pre-Infarction Angina On The Short-Term Prognosis Of Patients With STEMI Undergoing Emergency PCI

【 Background and Objective 】 Acute myocardial infarction(acute myocardial infarction, AMI) is a common critical clinical disease.As the incidence increased year by year, the high morbidity and mortality have brought enormous threat to individuals and society. How to reduce the incidence of myocardial infarction, how to improve the prognosis in patients after myocardial infarction, have become a focus in the study of medical workers. A large number of studies have shown that the early opening of infarction related artery can greatly reduce the myocardial infarction area, improve heart function, reduce mortality, which is one of the most effective treatment of myocardial infarction. Especially as the the development of percutaneous coronary interention(percutaneous coronary intervenetion, PCI) technology, significant progress has been made in the reperfusion of acute myocardial infarction treatment. But prognosis in these patients still exists significant differences, inductive factors include age, Killip classification, delay time of treatment, treatment patterns, past history of myocardial infarction, diabetes, renal dysfunction and coronary artery lesion counts etc. Researches in the impacting factors of prognosis in patients with myocardial infarction have always been the hot spots of the clinical researches. Foreign literature found that pre-infarction angina(after emergency PCI) in patients with myocardial infarction is a protective factor. In this paper, through a retrospective case observation, we discussed the impact of pre-infarction angina on the short-term prognosis in patients with ST-segment elevation myocardial infarction undergoing emergency PCI. Then help us judge the prognosis of acute myocardial infarction.【Methods】 The study was conducted in the first hospital affiliated to Dalian Medical University. In this study 227 patients with STEMI undergoing emergency PCI during the period January 2014 to December 2014 were enrolled. 1. According to the history,these patients were divided into group A(pre-infarction angina group) and group B(non-preinfarction angina group).Compared two groups of patients with basic clinical data, CK, CK- MB peaks, LVEF and the incidence of heart failure, cardiac shock and malignant arrhythmia and death in hospital.2. According to the characteristics of pre-infaction angina, A group were divided into A1 group(resting angina pectoris group)and A2 group(non-resting angina pectoris group), compared two groups of patients with basic clinical data,CK, CK- MB peaks, LVEF and the incidence of heart failure,cardiac shock, malignant arrhythmia and death in hospital.【 Results 】 1. Comparion between Pre-infarction angina group(group A) and non-preinfartion angina group(group B) : peak CK(u/L)(1857.9±1599.9 vs 2620.3± 2032.2,P =0.005), the difference was statistically significant; CK- MB(u/L) peak(141.5 ±117.3 vs 196.3±157.7,P =0.019), the difference was statistically significant;LVEF(%)(51.8 ± 7.4 vs 50.9 ± 6.3, P =0.016), the difference was statistically significant. Heart failure( 27.5% vs 42.4 %, P =0.026), the difference was statistically significant; malignant arrhythmia(14.7% vs 28.0%,P =0.016), the difference was statistically significant; Shock(2.8% vs 7.6%,P =0.139), there was no statistically significant difference; Death(2.8% vs 4.2%,P =0.723), there was no statistically significant difference.2. Resting angina pectoris group(A1) and non-resting angina pectoris group(group A2) comparing the two groups: the peak CK(u/L)(1619.7±1293.3 vs 2059.7±1806.3, P =0.341);CK- MB(u/L) peak(137.9 ± 121.9 vs 144.6 ± 114.3,P=0.406);LVEF(%)(52.4 ± 7.1 vs 51.5 ± 7.7, P =0.400);Heart failure(24.0% vs30.5%, P =0.521);Shock(0 vs 5.1%,P =0.248);Malignant arrhythmia(16.0% vs 13.6%,P =0.790);Death(2.0% vs 3.4%,P =1.000).No statistically significant difference were observed in the two groups.【Conclusions】 1. Pre-infarction angina is an effective protection factor in patients with STEMI undergoing emergency PCI, it can reduce the degree of myocardial necrosis, heart function damage, heart failure, malignant arrhythmia.2.Whether there is resting angina pectoris or not, patients with STEMI undergoing emergency PCI,the incidence of heart failure, malignant arrhythmia, cardiac shock, the incidence of inpatient death is no difference.