Analysis of factors related to cardiac dysfunctions in patients with non-ST segment elevation acute coronary syndrome after percutaneous coronary intervention / 中国医师进修杂志

ABSTRACT

Objective To investigate the factors related to cardiac dysfunctions during the percutaneous coronary intervention (PCI) in patients with non-ST segment elevation acute coronary syndrome (NSTEACS).Methods Patients diagnosed as NSTEACS receiving PCI from September 2007 to June 2018 were collected in the data base of medical record management system in Qingdao Eighth People's Hospital.Patients with cardiac dysfunctions (≥ Killip Ⅱ grade) within 1 week after PCI were included into the case group,while patients with normal cardiac function (Killip Ⅰ grade) within 1 week after PCI were included into the control group.Firstly,baseline data of age,gender,histories of hypertension,histories of type 2 diabetes,histories of high cholesterol,histories of smoking,histories of drinking,histories of myocardial infarction,NSTEACS risk stratifications,the application of platelet glycoprotein (GP) Ⅱ b/Ⅲ a receptor antagonists,coronary artery SYNTAX scores,the dose of contrast agent during PCI,the peak cardiac troponin (cTnT) and N-terminal pro-brain natriuretic peptide (NT-proBNP) within 24 h after admission was compared between the two groups;then,factors with statistical differences (P ＜ 0.05) were analyzed by the multivariate logistic regression;at last,variables screening was performed through the backward method and likelihood ratio test.Results A total of 3927 patients with NSTEACS receiving PCI were enrolled.Mter patients with incomplete information were eliminated,313 patients were admitted to the case group and 2 906 patients were admitted to the controlled group.After the analysis of multivariate logistic regression and variables screening,it showed that ＞ 80 years old (OR =1.758,95％ CI 1.129 to 2.367,P =0.014),increased dose of contrast agent (OR =1.083,95％ CI 1.007 to 1.274,P =0.020),the peak cTnT ＞ 0.2 μg/L (OR =2.102,95％ CI 1.703 to 3.104,P =0.031) and NT-proBNP＞450 ng/L (OR =2.243,95％ CI 1.863 to 3.257,P =0.015) after admission were the risk factors of cardiac dysfunctions.Conclusions Advanced age (＞ 80 years old),increased dose of contrast agent during PCI,the peak cTnT ＞ 0.2 μg/L and NT-proBNP ＞ 450 ng/L within 24 h after admission could raise the risk of cardiac dysfunctions in patients with NSTEACS after PCI.