| Objectives The aim of this study is to investigate the relationship between serum lipoprotein a(LPa)and coronary slow flow(coronary slow flow CSF)phenomenon and short-term prognosis in patients with acute myocardial infarction(AMI)who underwent emergency percutaneous coronary intervention(PCI).Methods A total of 183 patients who underwent emergency interventional therapy for STEAMI in our hospital from 2017 to 2019 were collected,including 145 males and 38 females.The general data of the patients were collected,including sex,age,height and weight,history of smoking and drinking,previous history of diabetes and hypertension,and blood samples were drawn to test the whole biochemical items(myocardial enzymes,liver function,renal function,electrolyte,blood lipids,blood glucose)and blood coagulation series,and record the details of the patients during the operation(use of drugs,dilation pressure,occurrence of slow blood flow).MACE events were recorded during hospitalization.According to the blood flow during the operation,the patients were divided into CSF group and non-CSF group,and the patients were divided into MACE group and non-MACE group according to the observed prognosis during hospitalization,and the LP(a)levels of the two groups were compared.SPSS 22.0 software was used to analyze the data.Independent sample T test or ?2 test was used to compare the mean between the two groups,and binary Logistic regression was used in multivariate analysis(?= 0.05 P < 0.05).Results 1 The level of LP(a)in CSF group was higher than that in non-CSF group,but the difference was not statistically significant.The heart rate in CSF group was significantly lower than that in non-CSF group,and the difference was statistically significant(P < 0.05),but there was no significant difference in sex,age,smoking,drinking,diabetes,cerebrovascular disease,mean arterial pressure and body mass index between the two groups.2 Compared with the non-CSF group,the plasma total cholesterol level,plasma prothrombin time and platelet distribution width in the CSF group were significantly higher than those in the CSFfree group.There was no significant difference in plasma uric acid and potassium levels of LP(a),TG,LDL-C,HDL-C,APOA and APOB.3 The reperfusion time in CSF group was significantly higher than that in non-CSF group(P < 0.05),but there was no significant difference in pre-dilation pressure,stent release pressure,post-dilatation pressure,gateball time,onset time and preoperative TIMI grade between the two groups,P < 0.05.There was no significant difference in pre-dilation pressure,stent release pressure,post-dilatation pressure,gateball time,onset time and preoperative TIMI grade between CSF group and nonSCF group.4 Logistic multivariate analysis showed that prolonged reperfusion time,decreased heart rate and increased platelet distribution width were risk factors of no reflow(OR=1.187,P=0.033;OR=1.034,P=0.042;OR=1.014,P=0.021).5 Compared with the non-MACE group,the age of the MACE group was significantly older than that of the nonMACE group,and the difference was statistically significant(P < 0.011).There was no significant difference in gender,smoking history,drinking history,hypertension history and body mass index between the two groups.6 Compared with non-MACE group,the number of leukocytes and neutrophils in MACE group was significantly higher than that in non-MACE group,and the difference was statistically significant.There was no significant difference in LP(a),TC,LDL-C,APOA,APOB,TG,Cr,k,PLT,FIB,GLU and TP between the two groups.7 Logistic multivariate analysis showed that age and white blood cells were independent risk factors for MACE events(OR=0.951 0.012 ~ 0.826 ~ 0.002).8 There was no significant difference in preoperative TIMI blood flow grade and CSF between MACE group and non-MACE group.Conclusions 1 In this study,no correlation was found between LP(a)and no reflow during emergency interventional therapy and short-term MACE events after emergency percutaneous coronary intervention in patients with acute ST segment elevation myocardial infarction.2 Prolonged reperfusion time,increased platelet distribution width and decreased heart rate are the risk factors of no reflow during the operation of acute ST segment elevation myocardial infarction.3 Advanced age and elevated white blood cell level at onset are risk factors for short-term MACE events after emergency percutaneous coronary intervention in patients with acute ST segment elevation myocardial infarction.Figure 0;Table 10;Reference 125... |
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