Analysis Of Risk Factors For Ventricular Aneurysm Due To Acute Anterior Wall Myocardial Infarction After Primary Percutaneous Coronary Intervention

Objective: To analysis the risk factors for ventricular aneurysm(VA)due to acute anterior wall myocardial infarction(MI)after primary percutaneous coronary intervention(PPCI).Method: A total of 367 consecutive inpatients with acute anterior myocardial infarction after Primary Percutaneous Coronary Intervention hospitalized from January 2015 to July 2017 in cardiovascular hospital affiliated to Xiamen University were enrolled in this study.Patients were divided into two groups: VA group(n=53)and non-VA group(n=314).All clinical data were collected by cardiologists.Finally,all of the risk factors for VA in the acute anterior myocardial infarction patients were quantitatively analyzed by a binary logistic regression model.Result: In a univariate analysis,symptom-onset-to-balloon time>12 hours(35.8% vs.17.5%,P=0.002),total occlusion of the left anterior descending branch(83.0% vs.66.2%,P=0.02),Killip ≥Ⅱ class(43.4% vs.26.1%,P=0.04),peak High Sensitivity Troponin T(hs-cTnT)≥10000pg/ml(35.8% vs.14.6%),left ventricular thrombus(9.4% vs.1.0%,P=0.001),left ventricular ejection fraction[(48.3±11.4)% vs.(52.3±11.8)%,P=0.03)],Angiotensin-Converting Enzyme Inhibitors(ACEIs)or Angiotensin Receptor Blockers(ARBs)in hospital(54.7% vs.70.7%,P=0.02),the presence of a pathological Q wave in precordial leads before primary percutaneous coronary intervention(90.0% vs.60.6%,P<0.001),T wave inversion in precordial leads before primary percutaneous coronary intervention(47.5% vs.23.1%,P=0.001).All of the above factors were significant differences between the VA group and non-VA group.Multivariate logistic regression analysis revealed that total occlusion of the left anterior descending branch,peak hs-cTnT≥10000pg/ml,symptom-onset-to-balloon time>12 hours,the presence of a pathological Q wave in precordial leads before primary percutaneous coronary intervention and T wave inversion in precordial leads before primary percutaneous coronary intervention were all associated with VA due to acute anterior wall myocardial infarction after primary percutaneous coronary intervention,with the odds ratio(OR)3.324,2.781,4.822,4.529,3.797(all P<0.05).Conclusion: Total occlusion of the left anterior descending branch,peak hs-cTnT≥10000pg/ml,symptom-onset-to-balloon time>12 hours,the presence of a pathological Q wave in precordial leads before primary percutaneous coronary intervention and T wave inversion in precordial leads before primary percutaneous coronary intervention were all independent risk factors for VA due to in acute anterior wall myocardial infarction after primary percutaneous coronary intervention.