急诊PCI术后早期左室收缩功能保留患者心力衰竭的预测因素分析

doi:10.3969/j.issn.1002-1949.2016.05.005

Chinese Journal of Critical Care Medicine

2016, Vol. 36

Issue (5): 401-405 DOI: 10.3969/j.issn.1002-1949.2016.05.005

Analysis on the predictive factors of heart failure after recanalization of IRA for AMI patients with preserved systolic function of left ventricle

XU Jia-liang, LIU Ming, HE Zhi-song, CHENG Xu-jie, JIANG Ting-bo

Department of Cardiology, the First Affiliated Hospital of Soochow University, Su?zhou 215006, China

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Abstract Objective To investigate the risk and predictive factors for the occurrence of heart failure after recanalization of infarct- related artery (IRA) during percutaneous coronary intervention(PCI) for acute myocardial infarction (AMI) patients with preserved systolic function of left ventricle.Methods 413 AMI patients with preserved ejection fraction who were treated by the PCI from January 2013 to April 2015 in hospital were divided into heart failure group and control group, and their clinical data were statistically analyzed. Risk factors related to heart failure were analyzed by multifactorial logistic regression analysis and the predicted effect was determined by ROC curve. Results ①The heart failure of AMI patients with preserved systolic function of left ventricle was positively associated with left atrial diameter, women, the infarct artery of left main coronary artery or left anterior descending branch,proximal vessel infarction, multi-vessel lesion, neutrophil, hs-CRP, LVS, vascular opening time and history of hypertension, where the difference between groups was statistically significant (P＜0.05). ② Mul⁃tifactorial logistic regression analysis showed that women, the infarct artery of left main coronary artery or left anterior descending branch, proximal vessel infarction, multi-vessel lesion, neutrophil, hs-CRP, vascular opening time and history of hypertension were independent predictors of heart failure. ROC curve analysis for this prediction model showed that the area under the curve was 0.783 (95%CI 0.739～0.828，P＜0.001). Conclusion Women, the infarct artery of left main coronary artery or left anterior descending branch, proximal vessel infarction, multi-vessel lesion, high neutrophil, high hs-CRP, long vascular opening time and history of hypertension can increase the possibility for patients with preserved systolic function of left ventricle of heart failure after PCI, and can reduce the incidence of it after PCI.

Received: 06 September 2015

Corresponding Authors: JIANG Ting-bo, E-mail：szjtb@medmail.com.cn

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http://www.cnemergency.org.cn/EN/10.3969/j.issn.1002-1949.2016.05.005 OR http://www.cnemergency.org.cn/EN/Y2016/V36/I5/401

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