Analysis of predictors and prognosis of spontaneous reperfusion in patients with acute ST-segment elevation myocardial infarction

Gao Yasong; Ding Chao

doi:10.3969/j.issn.1674-4055.2018.01.17

Abstract：Objective To observe the clinical characteristics and angiographic features of spontaneous reperfusion(SR) in patients with acute ST-segment elevation myocardial infarction (STEMI); to explore the predictors of SR in infarct related artery (IRA); to evaluate the prognosis of the two groups. Method 206 patients with acute STEMI and received emergent percutaneous coronary intervention (PCI) were included. According to the results of coronary angiography (CAG), 56 patients of SR group were defined as the TIMI2-3 grade and 150 patients of NSR group were defined as TIMI 0-1 grade. The clinical features, angiographic features and prognosis of the two groups were analyzed for investigation of the predictors of SR. Result The ratio of pre-infarction angina, ECG down > 50% and IRA located in LAD in SR group were higher than that in NSR group (all P<0.05). Stressful hyperglycemia and myocardial bridge were lower (both P<0.05). The levels of preoperative chest pain relief score, onset-to-medical therapy time , CK, CK-MB, cTnl, Scr NLR and PLR in SR group were lower than in NSR group (all P<0.05). Results of multivariable logistic regression analysis showed that pre-infarction angina, onset-to-medical therapy time , ECG down more than 50%, NLR and PLR can be used as predictors of SR. The incidence of major adverse cardiovascular events (MACE) in the SR group was lower than that in the NSR group ( P<0.05), and the cardiac function in SR group is better than in NSR group (P<0.05) at three months later. Conclusion There were certain rate of SR in acute STEMI patients before PCI treatment. Pre-infarction angina, onset-to-medical therapy time, ECG down more than 50%, NLR and PLR can be used as predictors of SR. SR can reduce the incidence of MACE during hospitalization, and be beneficial to the prognosis of patients.