Analysis Of Risk Factors Of Left Ventricular Aneurysm After Percutaneous Coronary Intervention In Patients With Acute ST Segment Elevation Myocardial Infarction

Objective:The purpose of this study was to investigate the risk factors for the formation of left ventricular aneurysm after interventional therapy in patients with acute ST segment elevation myocardial infarction.Methods: The clinical data of 1763 patients with ST-segment elevation myocardial infarction(STEMI)in the database of acute myocardial infarction in Xianyang Hospital of Yan'an University from January 2013 to January 2019 were analyzed retrospectively.In patients with STEMI complicated with segmental wall motion abnormality(RWMA),the baseline,coronary angiography and operative characteristics of LVA patients were compared with those of patients without LVA.The admission date of(LVA)patients with left ventricular aneurysm in the control group was matched at 2:1.Patients with previous history of myocardial infarction,non-ischemic cardiomyopathy,severe valvular heart disease and no coronary angiography were excluded.The odds ratio(OR)and confidence interval(CI)of each factor were obtained by Logistic regression analysis.SPSS25.0 software was used for statistical analysis.Results: Among the 1763 STEMI patients who underwent coronary angiography,98 eligible patients(median age 68 years old)had left ventricular aneurysm(LVA),196 patients(median age 61 years old)without LVA.Multivariate analysis showed that left ventricular anterior wall RWMA(OR=13.11,95%CI:2.13~79.4,p=0.005)was the most significant predictor,followed by apical RWMA(OR=7.89,95%CI:2.31~29.4,P= 0.001).Female(OR=3.95,95%CI:1.52~9.89,p=0.004),peak N-terminal brain natriuretic peptide(NT-pro BNP,OR=1.10,95%CI:1.03~1.36,p=0.032),time of pain onset to balloon(OR=1.05,95%CI:1.02~1.05,p=0.015),first ECG QS Wave(OR=3.18,95%CI: 1.53~6.18,p=0.002)are independent risk factors for the formation of left ventricular aneurysm.Conclusion:Female,peak NT-proBNP,time from onset of pain to balloon,appearance of QS wave in the first electrocardiogram,abnormal left ventricular anterior wall and apical segmental wall motion(RWMA)are independent risk factors for LVA after interventional therapy in patients with acute STEMI.