Predictive factors of acute ST-segment elevation myocardial infarction patients with spontaneous reperfusion

doi:10.3969/j.issn.1006-7795.2015.03.010

Abstract

Abstract:

Objective To explore the clinical implications of different evaluation methods and value for the prediction of spontaneous reperfusion in ST-segment elevation myocardial infarction (STEMI). Methods A total of 260 patients who underwent coronary angiography (CAG) were enrolled. The patients were divided into spontaneous reperfusion (SR, TIMI flow grade 3 identified by CAG) group (n=67) and nonspontaneous reperfusion (NSR, TIMI flow grade 0-2 identified by CAG) group (n=193). We analyzed the predictive value of ST-segment resolution (STR), hemoglobin (Hb), and high-sensitivity C-reactive protein (hsCRP) in SR in acute myocardial infarction (AMI). Results There was significant difference in ST-segment resolution, symptoms release, Hb, creatinine, uric acid, MB isoenzyme of creatine kinases, and hsCRP between two groups. In Logistic regression model, Hb (OR=1.064,95%CI:1.036-1.094,P=0.000), hsCRP (OR=0.811,95%CI:0.713-0.923,P=0.001) and STR>50% (OR=3.638,95%CI:1.793-7.318,P=0.000) were independent predictors for SR. The receiver-operating characteristic curve (ROC) analysis for Hb, hsCRP, and STR combined in predicting spontaneous reperfusion showed sensitivity of 80.6%, specificity of 63.7%, and area under the curve (AUC)=0.78(0.72-0.85). Conclusion Hb, hsCRP and STR have predictive value for SR.

Key words: acute ST-segment elevation myocardial infarction, spontaneous reperfusion, ST-segment resolution, hemoglobin, high-sensitivity C-reactive protein, predictive value

CLC Number:

R542

Wang Jun, Hua Qi, Li Xiaoming, Xue Song, Wang Yunfei, Wang Li, Fan Zhenxing, Kong Qiang, Wang Yanling, Li Jing. Predictive factors of acute ST-segment elevation myocardial infarction patients with spontaneous reperfusion[J]. Journal of Capital Medical University, 2015, 36(3): 388-392.

0
/ / Recommend

Add to citation manager EndNote|Reference Manager|ProCite|BibTeX|RefWorks

URL: https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/10.3969/j.issn.1006-7795.2015.03.010

https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/Y2015/V36/I3/388

References

[1] Brener S J, Mehran R, Brodie B R, et al. Predictors and implications of coronary infarct artery patency at initial angiography in patients with acute myocardial infarction (from the CADILLAC and HORIZONS-AMI Trial)[J]. Am J Cardiol, 2011, 108(7): 918-923.
[2] Kirchberger I, Heier M, Kuch B, et al. Presenting symptoms of myocardial infarction predict short-and long-term mortality: the MONICA/KORA Myocardial Infarcion Registry[J]. Am Heart J, 2012, 164(6): 856-861.
[3] 王云飞, 李小明, 华琦, 等. 急性心肌梗死自发再灌注预测因素及其短期预后[J]. 中国心血管杂志, 2014, 19(1): 20-23.
[4] Steg P G, James S K, Atar D, et al. ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation[J]. Eur Heart J, 2012, 33(20): 2569-2619.
[5] Yokoyama K, Daida H. Selective coronary angiography[J]. Nihon Rinsho, 2011, 69 (Suppl 7): 206-215.
[6] Grundeken M J, Vis M M, Beijk M A, et al. Clinical outcomes after percutaneous or surgical revascularization of unprotected left main coronary artery-related acute myocardial infarction: a single-center experience[J]. Heart, 2013, 99(10): 690-699.
[7] 王健, 颜红兵, 郑斌, 等. 急性ST段抬高型心肌梗死自发再灌注患者的临床及造影特点分析[J]. 中国循证医学杂志, 2012, 12(3): 289-292.
[8] Hanna E B,Alexander K P,Chen A Y,et al. Characteristics and in-hospital outcomes of patients with non-ST-segment elevation myocardial infarctionundergoing an invasive strategy according to hemoglobin levels[J]. Am J Cardiol, 2013, 111(8):1099-1103.
[9] 王鑫,孙振国,胡志成,等.急性冠脉综合征不同程度冠脉病变患者血浆高敏C反应蛋白检测及意义[J].中国循证心血管医学杂志,2010, 2(3): 156-158.
[10] Lee J H, Yang D H, Jang S Y, et al. Incremental predictive value of red cell distribution width for 12-month clinical outcome after acute myocardial infarction[J]. Clin Cardiol, 2013, 36(6): 336-341.
[11] 刘晓东,张冠茂,刘节武,等.急性心肌梗死患者住院期间新发心房颤动的多因素分析[J]. 中国医科大学学报,2013,42(11):1036-1039.
[12] 郭洁,李俊峡.冠状动脉易损斑块的早期识别研究进展[J]. 临床误诊误治, 2012,25(5):97-100.
[13] 霍阳,初巍巍,贾大林,等.不同剂量瑞舒伐他汀对急性冠状动脉综合征患者血清C-反应蛋白、尿酸和血脂水平的影响[J]. 解放军医药杂志,2014,26(2):75-77.

[1]	Miao Zupei, Zhang Yinghua, Xiao Keling, Si Jin, Zhang Haoyu, Li Jing. Influence of obesity on the prognosis of patients with STEMI [J]. Journal of Capital Medical University, 2022, 43(2): 192-198.
[2]	Sun Hao, Zheng Meili, Guo Zongsheng, Zhang Zhiyong, Li Xiaotao. The prognostic importance of left ventricular systolic function in patients with acute inferior ST-segment elevation myocardial infarction undergoing percutaneous coronary intervention [J]. Journal of Capital Medical University, 2022, 43(2): 305-310.
[3]	Mei Man, Ren Tianhua. Study on the correlation between venous blood and arterial blood gas electrolyte hemoglobin concentration [J]. Journal of Capital Medical University, 2020, 41(2): 267-271.
[4]	Hao Peng, Feng Siting, Zhen Lei, Wang Xiao, Wang Chunmei, Nie Shaoping. Value of SYNTAX score Ⅱ to predict no-reflow of prior percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction [J]. Journal of Capital Medical University, 2019, 40(5): 744-748.
[5]	Tao Lixin, Mao Qi, Guo Xiuhua, Sun Dianqin, Tian Feifei, Yan Yan. Relationship between mean corpuscular hemoglobin concentration and diabetes mellitus in health examination population in Beijing [J]. Journal of Capital Medical University, 2018, 39(4): 575-580.
[6]	Zhou Yaqun, Ding Cuntao, Sun Xipeng, Li Jing, Zhu Weiwei, Hua Qi. Effect of high-sensitive C-reactive protein on vascular endothelial function in patients with essential hypertension [J]. Journal of Capital Medical University, 2017, 38(3): 397-400.
[7]	Yang Weiwei, Li Xuran, Li Xin, Li Xuying, Yu Shun. Expression of neuronal hemoglobin alleviates α-synuclein-induced apoptosis in MES23.5 cells [J]. Journal of Capital Medical University, 2016, 37(6): 799-805.
[8]	Yang Weiwei, Li Xuran, Li Xin, Li Xuying, Yu Shun. Neuronal hemoglobin in mitochondria is reduced by forming a complex with α-synuclein [J]. Journal of Capital Medical University, 2016, 37(5): 621-625.
[9]	Song Zihui, Zhang Huixia, Xiang Zongshang, Fan Mingyuan, Cai Yongming, Zhang Zongpeng. Antihyperglycemic effect of glargine injection in rat model of type 1 diabetes [J]. Journal of Capital Medical University, 2016, 37(5): 646-650.
[10]	Fang Fang, Chen Kelin, Chen Yan, Huang Zeyu, Lyu Hong, Liu Shujing, Zhou Jin, Zhang Guojun, Kang Xixiong. Evaluation of anti-interference capability of HBV DNA quantitative reagents according to CNAS CL-36 criterion [J]. Journal of Capital Medical University, 2016, 37(4): 495-499.
[11]	Liu Xiangtong, Tao Lixin, Yang Kun, Li Haibin, Guo Jin, Guo Xiuhua. Association between hemoglobin and metabolic syndrome: a five-year follow-up [J]. Journal of Capital Medical University, 2016, 37(4): 509-512.
[12]	Li Xuying, Li Xin, Li Xuran, Yang Weiwei, Yu Lan, Wang Peng, Yu Shun. Preparation and identification of anti-hemoglobin monoclonal antibody [J]. Journal of Capital Medical University, 2015, 36(5): 684-688.
[13]	GUAN Xinliang;AI Hui;WANG Chunmei;LI Yanfang;ZHU Xiaoling. Clinical value of reciprocal ST-segment depression in patients with acute ST-segment elevation myocardial infarction [J]. Journal of Capital Medical University, 2012, 33(6): 818-821.
[14]	XIN Zhong;YUAN Ming-xia;FENG Jian-ping;SHI Jing;ZHU Xiao-rong;YANG Jin-kui. Comparison for Association of Fasting and 2-hour Glucose and HbA1c with Diabetic Retinopathy [J]. Journal of Capital Medical University, 2012, 33(4): 477-480.
[15]	MA Jin-li;ZHU Cheng-yi. Relationship between retinopathy in type 2 diabetics and glycated hemoglobin [J]. Journal of Capital Medical University, 2011, 32(4): 562-564.