Effect Of BMI,Age And Killip Grade On Short-Term Prognosis Of Patients With Acute Myocardial Infarction After PCI

BackgroundAcute myocardial infarction can cause dramatic changes in hemodynamics within a short period of time.Although PCI can reduce mortality in patients with myocardial infarction,there is still a possibility of adverse outcomes.Prediction of short-term adverse events in patients with acute myocardial infarction after PCI is helpful to evaluate patients’ condition more effectively and make diagnosis and treatment plan.Therefore,in order to explore a simple and feasible prognosis evaluation index for patients with myocardial infarction after PCI,this study intends to compare the clinical characteristics of patients with low body weight,normal body weight and overweight myocardial infarction,and explore the influence and predictive value of BMI combined with age and Killip on short-term prognosis of patients with acute myocardial infarction after PCI.ObjectiveTo investigate the effect of BMI combined with age and Killip grade on short-term prognosis of patients with acute myocardial infarction after PCI,and to predict the occurrence of adverse events.MethodsPatients with acute myocardial infarction hospitalized in The Second Affiliated Hospital of Guangzhou Medical University from June 1,2019 to June 1,2022 were included in this study to collect relevant clinical data.First,Establish logistic regression model was used to analyze the risk factors for Major Adverse Cardiac Events(MACE)within 30 days after discharge.Secondly,multiple logistic regression was used to adjust the potential confounding factors,and the independent risk factors and their Odd ratio(OR)were obtained.Then,ROC curve was used to evaluate the predictive ability of BMI,age,Killip class and the combination of the three indexes to the occurrence of short-term MACE.Finally,stratified analysis was conducted on factors that may affect the prognosis of myocardial infarction,such as age,type of myocardial infarction and gender,to further understand the correlation between BMI and the occurrence of short-term MACE in patients with myocardial infarction after PCI.ResultsIn this study,400 patients with acute myocardial infarction were included for data analysis and divided into emaciated group,normal group and obese group.Univariate logistic regression analysis showed that BMI group,age,Killip class,albumin,Left Ventricular Ejection Fractions(LVEF)and resting heart rate were significantly different in the occurrence of MACE events(P < 0.05).After adjusting for potential confounding factors(albumin,LVEF,resting heart rate),multivariate logistic regression analysis showed that the risk of MACE events in the emaciated group was 4.585 times higher than that in the normal group(OR 4.585,95%CI:1.069-19.664,P=0.04).The risk of MACE events increased by 9.7% for each additional year of age(OR 1.097,95%CI:1.027-1.173,P=0.006);The risk of MACE events increased by 2.131 times for each Killip class increase(OR 2.131,95%CI:1.140-3.981,P=0.018).Stratified analysis showed that non-emaciated patients had a lower risk of MACE events than emaciated patients in older,STEMI,and female patients.ROC curve was used to analyze and compare the prediction efficiency of age,Killip class,BMI grouping and combined index,and the AUC values were 0.841,0.729 and0.542,respectively.Combined index could improve the prediction efficiency(AUC value was 0.870).Patients at high risk of MACE events were more easily identified(sensitivity81.80%,specificity 83.00%).Conclusion1.In patients with acute myocardial infarction who underwent PCI,patients with low BMI or emaciation had a higher risk of adverse events during hospitalization and MACE events within 30 days of discharge.Age and Killip grade were positively correlated with the risk of MACE events;2.BMI had limited predictive value for MACE events during hospitalization and within 30 days of discharge,but BMI combined with age and Killip grades significantly improved the predictive efficacy.