Clinical study on microcirculation resistance index for predicting major adverse cardiac events after PCI operation in patients with ST segment elevation myocardial infarction / 重庆医学

ABSTRACT

Objective To investigate the clinical value of the index of microcirculation resistance(IMR) in the prediction of major adverse cardiac events after PCI in the patients with ST segment elevation myocardial infarction.Methods Forty-eight inpa tients with acute ST segment elevation myocardial infarction(STEMI) in the cardiology department CCU of our hospital from December 2013 to June 2015 were selected,including 38 males and 10 females,and divided into 3 groups according to the measured IMR value after PCI operationthe group A,IMR≤25(n=18);group B,IMR 25 ～ 32 (n =16);group C,IMR≥32 (n =14).Serum NT-ProBNP was collected,and the data in cardiac color ultrasound after PCI and at postoperative 1 yearleft ventricular ejection fraction(LVEF) and left ventricular end diastolic diameter(LVEDD),and major adverse cardiac events within 1 years after PCI were also collected.Results The serum of concentrations NT-ProBNP were compared among the three groups[(2 734.83 ± 1 009.40) vs.(4 929.68±611.52) vs.(7 480.64±2 082.78)],and the difference among 3 groups was statistically significant (F=35.449,P=0.000).The difference of LVEF among the three groups had statistal significance[(54.00-±-5.99) vs.(52.31 ± 4.35)vs.(49.29 ±4.68),F=3.376,P=0.043)],and there was no statistical difference among the three groups in LVEDD(P＞0.05).The difference of LVEF at postoperative 1 year among 3 groups had statistical significance[(57.28 ± 5.21)vs.(54.43 ±3.69)vs.(46.43±5.33),F=16.744,P=0.000],and the difference of LVEDD (48.94±1.95)vs.(50.63±2.68)vs.(52.14±2.69) among 3 groups was statistically significant(F=6.875,P=0.002).The differences in the major adverse cardiac events,cases of cardiac death and cases of heart failure after postoperative 1 year among 3 groups were statistically significant(x2 value=6.707,P=0.035;x2 value=6.084,P=0.048);the occurrence of again ACS,again PCI and malignant arrhythmia had no statistical difference among 3 groups(P＞0.05).Conclusion Measurement of IMR after PCI in the patients with STEMI can effectively predict the heart function and the risk of major adverse cardiac events within 1 year.