Effect Of Selective PCI On Left Ventricular Function In Patients With Acute ST Segment Elevation Myocardial Infarction

Objective To investigate the effect of selective PCI on left ventricular function in patients with STEMI and analyze the risk factors of left ventricular dysfunction in patients with STEMI.Methods A retrospective analysis of 126 patients firstly diagnosed of STEMI in Enshi Central Hospital from January 2018 to October 2019 was performed.According to different treatment methods,126 patients were divided into selective PCI group and drug group and the effect of two treatment methods on left ventricular function were compared.According to whether patients suffered from left ventricular dysfunction after 6 months of follow-up,patients were divided into cardiac dysfunction group and normal cardiac function group and the factors related with cardiac function in STEMI patients were analysed.Result(1)Follow-up for 6 months after treatment,the left ventricular ejection fraction(LVEF)of selective PCI group was significantly higher than that before operation(P<0.05).(2)Follow-up for 6 months after treatment,the LVEF of selective PCI group was significantly higher than that of drug group(P<0.05).(3)Follow-up for 6 months after treatment,the proportion of NT-proBNP normal in selective PCI group was higher than that in drug group(P<0.05).(4)Follow-up for 6 months after treatment,the proportion of NT-proBNP normal in selective PCI group was significantly higher than that of before operation(P<0.05).(5)Follow-up for 6 months after treatment,the cardiac function grade(NYHA)of selective PCI group was significantly better than that of drug group(P<0.05).(6)Follow-up for 6 months after treatment,the selective PCI group heart failure and total MACE were significantly lower than the drug group,the difference between the two groups was statistically significant(P<0.05).(7)The logistic binary regression analysis: age increased the risk of cardiac dysfunction in patients with STEMI(OR=1.066,95%CI:1.015-1.119,P=0.010).Selective PCI treatment(OR = 0.268,95%CI:0.109-0.659,P = 0.004)andonset LVEF(OR=0.955,95%CI:0.914-0.998,P=0.041)reduced the risk of cardiac dysfunction in patients with STEMI.Conclusion(1)Selective PCI can improve cardiac function in patients with STEMI.(2)Age is independent risk factors of cardiac dysfunction in patients with STEMI,selective PCI treatment and onset LVEF are the protective factor to avoid cardiac dysfunction in patients with STEMI.