Liu X.,Henan Peoples Provincial Hospital |
Qin L.,Henan Peoples Provincial Hospital |
He W.,Henan Peoples Provincial Hospital |
Xu W.,Henan Peoples Provincial Hospital |
And 3 more authors.
Chinese Journal of Emergency Medicine | Year: 2014
Objective To survey ST-segment resolution in STEMI patients undergoing emergency percutaneous coronary intervention (PCI) and to find the specific clinical features of patients with inadequate ST-segment resolution. Methods A total of 198 patients were divided into two groups according to the ratio of ST-segment resolution: relatively adequate ST-segment resolution group ( > 50% ) and inadequate ST- segment resolution group ( < 50% ). The clinical features, infarct-related artery and PCI-related evants were evaluated, and major adverse cardiovascular events ( MACE including target vessel revascularization, recurrent myocardial infarction, or death) were recorded during hospitalization and follow-up period. Multivariate logistic analysis was used to identify relevant factors influencing ST-segment resolution of STEMI patients after treatment with PCI. The Statistical analyses of data were carried out using SPSS 10. 0 software. Results (1) There were 156 patients with relativey adequate ST-segment resolution and 42 patients with inadequate ST-segment resolution. Of them, there were higher percentage of patients aged over 75years in the inadequate ST-segment resolution group than those in the relatively adequate ST-segment resolution group (9 cases, 21.4% vs. 14 cases, 9.0%; P<0.05) . (2) In inadequate ST-segment resolution group, the total ischemic time was significant longer [ (5. 2 ±2. 2) h vs. (3. 0 ± 1. 6) h, P <0. 01 ]. The infarct- related artery (IRA) was more common at left anterior descending coronary artery ( LAD) (27 cases, 64.3% vs. 69 cases, 44.2% ; P < 0.05) and there were fewer patients with TIM grade 3 of IRA in inadequate ST-segment resolution group after primary PCI than that in relative adequate ST-segment resolution group (32 cases, 76. 2% vs. 140 cases, 89. 7% ; P < 0. 05). There was a lower rate of using GP D b/ ID a receptor antagonist and a higher rate of prescribing IABP in inadequate ST-segment resolution group. (3) There is a higher incidence of MACE during hospitalization and follow-up period in patients with inadequate ST-segment resolution. (4) Multivariate logistic analysis indicated that age over 75 years, LAD occlusion, the total ischemic time were related to ST-segment resolution. Conclusions The patients with age over 75 years, LAD occlusion, longer ischemia time, and unemployment GP II b/ DI a receptor antagonist before PCI were prone to get inadequate ST-segment resolution and poor prognosis. Age over 75 years, LAD occlusion, and longer ischemic time were independent risk factors of the inadequate ST-segment resolution in STEMI patients after emergency PCI. Copyright © 2014 by the Chinese Medical Association.