| Objective:The risk factors and prognosis of combined ejection fraction preserved heart failure after emergency PCI in AMI patients were analysed to provide a basis for the prevention and treatment of HFp EF after emergency PCI in AMI patients.Methods:335 patients(81 patients in the HFp EF group,254 patients in the normal cardiac function group)who were hospitalized for AMI and treated with emergency PCI surgery in our hospital between January 1,2021 and December 31,2021 were included,and the basic vital signs,serological indicators,echocardiographic findings,coronary lesions and intraoperative disposition of all patients at the time of admission were Univariate statistical analyses were performed,and binary logistic regression analyses were performed for the various indicators where statistical differences existed.All patients were followed up for all-cause mortality,recurrent myocardial infarction and angina pectoris within 1 year of discharge,Survival curves were plotted by Kaplan-Meier survival function for all-cause mortality events at 1 year and the cumulative incidence of recurrent myocardial infarction and angina events at 1 year was statistically analysed by Kaplan-Meier curves.Results:1.Univariate analysis:(1)Basic vital signs on admission: 335 patients were included in the study,including 81 patients(24.18%)in the HFp EF group and 254 patients(75.82%)in the normal cardiac function group,58 patients(71.6%)were male in the HFp EF group,with a median age of 68 years;the median age of patients in the normal cardiac function group was 62 years,and the median age of patients in the HFp EF group was greater than that of the normal cardiac function group,with statistically significant differences(P<0.05).(2)Serological parameters: the concentrations of fasting glucose,mean platelet volume,initial cardiac troponin,initial B-type natriuretic peptide,peak B-type natriuretic peptide,D-dimer and fibrinogen were higher in the HFp EF group than in the normal cardiac function group,with statistically significant differences(P<0.05).(3)Echocardiographic indices: left ventricular end-diastolic diameter and left ventricular posterior wall thickness were greater in the HFp EF group than in the normal cardiac function group,with statistically significant differences(P<0.05).(4)Coronary artery lesions: the proportion of patients with LAD as the criminal vessel was greater in the HFp EF group than in the normal cardiac function group,the difference was statistically significant(P<0.05),and the proportion of patients with RCA as the criminal vessel was smaller in the HFp EF group than in the normal cardiac function group,the difference was statistically significant(P<0.05).2.Binary logistic regression analysis:Increasing age,increased fibrinogen concentration and thickening of the posterior left ventricular wall are independent risk factors for combined HFp EF after emergency PCI in patients with AMI.3.Survival analysis:The cumulative incidence of recurrent anginal events within 1 year after discharge was greater in the HFp EF group than in the normal cardiac function group(P<0.05).There was no statistical difference between the median survival time and recurrent myocardial infarction events within 1 year after discharge in the two groups(P>0.05).Conclusions:1.Elevated initial cardiac troponin concentrations,initial and peak B-type natriuretic peptide concentrations,fasting blood glucose concentrations,mean platelet volume and D-dimer concentrations may be associated with the development of HFp EF.2.Enlargement of the end-diastolic diameter of the left ventricle may be associated with the development of HFp EF.3.LAD as a criminal vessel may be associated with the development of HFp EF.4.Increasing age,increased fibrinogen concentration and thickening of the posterior left ventricular wall are independent risk factors for the development of HFp EF after emergency PCI in patients with AMI.5.Patients in the HFp EF group had a higher incidence of angina at 1 year after discharge than those in the normal cardiac function group. |
