Analysis Of Influencing Factors Of Time Delay In Interventional Treatment Of Acute ST-Segment Elevation Myocardial Infarction

Objective:To explore the influencing factors of time delay of interventional therapy in patients with acute ST-segment elevation myocardial infarction(STEMI),in order to shorten the reperfusion time of STEMI patients and find a feasible method to restore ischemic myocardial blood perfusion as soon as possible.Method:This study reviewed the general information and angiography of patients who underwent emergency percutaneous coronary intervention(PCI)who were admitted to the hospital from January 1st,2017 to March 30 th,2018,in the Sino-Japanese Friendship Hospital of Jilin University.Results and heart failure and death in the hospital.All patients identified three important time periods: patient delay time(SO-to-FMC time,ie time to first medical contact),system delay time(FMC-to-B time,ie first medical contact to balloon expansion time),in-hospital delay time(D2B time,that is,entry to balloon expansion time).Grouping: According to patient delay time(SO-to-FMC time),it is divided into ?90min group(group A)and >90min group(group B);according to system delay time(FMC-to-B time),it is divided into ? 120 min group(Group C)and >120min group(Group D);according to in-hospital delay time(D2B time),it was divided into ?90min group(group E)and >90min group(group F).The factors related to patient delay,system delay and in-hospital delay were compared and analyzed.The information of each influencing factor was included in logistic regression analysis to deal with related factors,and the influencing factors of each time period were analyzed.P < 0.05 was considered statistically significant.Results:1.45.8% of the patients had SO-to-FMC(delayed)time ? 90 min.there were significant differences in sex,diabetes,hypertension,incidence in urban area and calling for help between group A and group B(P < 0.05).Regarding the influencing factors of patient delayed time,Logistic regression analysis showed that the incidence,gender,transfer and call 120 were independent influencing factors of patients' delay time > 90 minutes in urban area of this city.Women were independent risk factors of patients' delay time.The incidence,call 120 and transfer in urban area of this city were independent predictors of patients' delayed time shortening.2.58.4% of patients had FMC-to-B(system delay)time ?120min.Patients in group C and D were transferred to hospital,at their own expense,and the incidence of SO-to-FMC in the city was >90min.The difference between the two groups was statistically significant.Significance(P<0.05).Logistic regression analysis showed that the abnormal working time,the transfer,the city's urban morbidity,the call for help 120,SO-to-FMC>90min,and the stent placement as the system delay time>120min independent influence factors.Abnormal working time,transfer,and call for help 120 are independent predictors of system delay time prolongation.The incidence of SO-to-FMC in urban areas is >90min,and the placement of stents is an independent prediction of FMC-to-B time shortening.factor.3.D2B(in-hospital delay)time compliance rate reached 86.2%,E,F group of patients with hyperlipidemia,nocturnal morbidity,abnormal working time,call for help 120,transfer,systolic blood pressure at admission,stent placement difference between the two groups Statistically significant(P < 0.05).Regarding the influencing factors of in-hospital delay time >90 min,the results of logistic regression analysis showed that the abnormal working time,snoring 120,transfer,hypertension,and systolic blood pressure at admission were independent influencing factors of in-hospital delay time >90 min.The incidence of abnormal working time,systolic blood pressure at admission was an independent predictor of prolonged delay in hospital,and call for help 120,transfer,hypertension,and stent placement were independent predictors of D2 B shortening.4.Patients with reduced ejection fraction(LVEF <50%)had a higher proportion in the SO-to-FMC>90min group than the ?90min group,and the difference was statistically significant(P=0.012).In-hospital mortality was greater in group D than in group C(2.4% > 1.7%),but there was no statistical difference.In-hospital mortality was higher in group F than in group E(2.9%>1.9%),but there was no statistical difference.Conclusion:1.Women are independent risk factors for prolonged delay of patients,while the incidence,call for help,and transfer to hospital in this city are independent predictors of shortened patient delay time.2.abnormal working time onset,transfer,and call for help 120 is an independent risk factor for prolonged system delay time.The incidence of SO-to-FMC in the city is >90min,and the placement of the stent is an independent predictor of system delay time shortening.3.abnormal working hours,systolic blood pressure at admission was an independent risk factor for prolonged hospital delay,while call for help 120,transfer,hypertension,placement of stent is an independent predictor of shortened in-hospital delay time.4.Patients with delayed(SO-to-FMC)time >90 min are more likely to have reduced left ventricular ejection fraction.