High-sensitivity C-reactive Protein Levels In Elderly Patients With Acute Myocardial Infarction Undergoing Emergency PCI And Its Clinical Significance

Objective:The degree of plasma high-sensitivity C-reactive protein measured in the first place in patients who underwent PCI was measured,and the blood supply area of the patient’s criminal blood vessels was observed during PCI.The degree of heart failure before and after surgery was evaluated.The ejection fraction,NT-proBNP value,and the incidence of postoperative acute myocardial infarction complications further confirmed that hs-CRP has a certain relationship with the long-term prognosis of elderly patients with acute myocardial infarction.Methods:176 patients with acute myocardial infarction admitted to the Department of Cardiology,Hebei University of Engineering and Shijiazhuang Bethune International Peace Hospital,from January 1,2017 to October 1,2018,and who underwent emergency PCI were selected.Serum hs-CRP was selected according to the enrolled patients.The level was 3 mg/L,and they were divided into two groups: 134 patients with plasma hs-CRP concentration >3 mg/L and 42 patients with plasma hs-CRP≤3mg/L;Collect detailed clinical data of inpatients,observe coronary artery condition in angiography during emergency PCI(criminal blood vessel blood supply area,non-criminal blood vessel stenosis degree,stenosis,etc.);postoperative routine operation of ECG blood pressure and blood pressure monitoring,next day extraction Fasting venous blood(high-sensitivity C-reactive protein,myocardial infarction,NT-proBNP,etc.),Doppler ultrasound to determine the cardiac function of the patients by cardiac ejection fraction,and record the occurrence of in-hospital complications such as malignant arrhythmia,Heart failure,cardiogenic shock,sudden cardiac death;According to the statistical data,the clinical data between patients with different plasma hs-CRP levels covered the difference between the location of the vascular lesion and the blood supply area,the degree of heart failure and the incidence of AMI complications in the hospital,and further verified Whether the incidence of AMI complications is related to plasma hs-CRP levels.Results: Compared with the plasma hs-CRP concentration of the two groups of patients,the blood supply area of the criminal blood vessels in the high concentration group was larger,which was statistically significant;The plasma hs-CRP concentrationsof the two groups were negatively correlated with the degree of heart failure(cardiac ejection fraction)in the high-concentration group(P<0.05),and positively correlated with the serum NT-proBNP concentration.Sex(P<0.05),serum high hs-CRP concentration group had the highest proportion of Killip IV patients(P<0.05);The plasma hs-CRP high concentration group is more likely to have complications of myocardial infarction after hospitalization,including malignant arrhythmia,cardiogenic shock,papillary muscle dysfunction,acute left heart failure,sudden cardiac death,etc.The incidence of sexual events(P <0.05);hs-CRP(OR=1.017)and NT-proBNP(OR=1.873)are two independent predictors of the incidence of myocardial infarction complications in elderly patients with acute myocardial infarction.Conclusions: The higher the plasma hs-CRP concentration in elderly patients with myocardial infarction,the larger the blood supply area of the infarct vessels and the higher the incidence of myocardial infarction complications during hospitalization,the more severe the heart failure;There is a correlation between plasma hs-CRP and prognosis in elderly patients with myocardial infarction;Plasma hs-CRP level is closely related to the occurrence of cardiovascular events after PCI in elderly patients with myocardial infarction,which may be an independent predictor of cardiovascular adverse events after PCI in elderly patients with acute myocardial infarction.