Analysis on influence factors of myocardial tissue perfusion in ST-segment elevation myocardial infarction patients undergoing primary percutaneous coronary intervention
Gao Yulong
Li Honghai
Zhang Jingmei
Tao Ying
Abstract：To analysis the influence factors of myocardial tissue perfusion in patients with ST-segment elevation myocardial infarction(STEMI) undergoing primary percutaneous coronary intervention(PCI). Methods The data of 782 STEMI patients undergoing primary PCI from January to December 2017 in Beijing Anzhen Hospital, Capital Medical University were analyzed retrospectively. The patients were divided into ST resolution(STR)＜50% group(n=131)and control group(STR≥50%, n=651). The myocardial perfusion was compared between the two groups, and the related factors were analyzed. Results The proportion of smoking, diabetes mellitus and reperfusion time in STR＜50% group were significantly higher than those in control group(all P＜0.05). The proportion of intracoronary tirofiban and intraoperative no-reflow/slow flow in STR＜50% group were significantly higher than those in the control group, with statistical significance(all P＜0.05). The ratio of TIMI blood flow, myocardial blush grade perfusion and TIMI myocardial perfusion perfusion to grade 3 in STR＜50% group were significantly lower than that in control group[85.5%(112/131) vs. 95.4%(621/651), 59.8%(78/131) vs. 90.1%(587/651), 64.5%(84/131) vs. 90.4%(589/651)], the difference were statistically significant(all P<0.05). Logistic regression analysis revealed that diabetes mellitus(odds ratio=2.81, 95% confidence interval: 1.20~6.48, P=0.021), reperfusion time(odds ratio=3.84, 95% confidence interval: 1.26~6.51, P=0.003), intracoronary tirofiban(odds ratio=1.25, 95% confidence interval:1.32~6.47, P=0.034) and intraoperative no reflow/slow flow(Odds ratio3.98, 95% confidence interval: 1.25~9.83, P＜0.001) were the factors affecting myocardial perfusion. Conclusions smoking history,history of diabetes and tissue perfusion time are independent risk factors of poor myocardial tissue perfusion during primary PCI in STEMI,Time of reperfusion is the most relevant factor.Attention should be paid to these clinical features, and we can reduce poor myocardial tissue perfusion incidence by opening infarct-related artery timely.
Keywords：ST-segment elevation myocardial infarctionPercutaneous coronary interventionST-segment resolutionMyocardial tissue perfusion
Publication Date：2019-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 101-104 )