Relationship between metabolic syndrome and heart failure in patients with acute myocardial infarction after percutaneous coronary intervention

Zhang Xueya; Guo Yingchun

doi:10.3969/j.issn.1674-4055.2023.10.16

Abstract：Objective To analyze the relationship between metabolic syndrome(MS)and heart failure(HF)in patients with acute myocardial infarction(AMI)after percutaneous coronary intervention(PCI).Methods The clinical materials of AMI patients(n=271)undergone PCI were retrospectively analyzed in Department of Cardiovascular Medicine in Chest Hospital of Henan Province from Mar.2018 to Mar.2022.The patients were divided,according to whether having complicated MS or not,into MS group(n=124)and non-MS group(n=147).The complication of HF was counted in all AMI patients after PCI.The general materials were compared between MS group and non-MS group.The incidence rate of HF was analyzed by using Kaplan-Meier survival curve in MS group and non-MS group.The influence factors of complicated HF were analyzed by using Cox regression analysis.Results The percentages of female cases,and cases with age≥65,hypertension history,diabetes history and hyperlipidemia history,body mass index(BMI),waistline,and levels of systolic blood pressure(SBP),diastolic blood pressure(DBP),heart rate(HR),fasting plasma glucose(FPG)and fasting triglyceride(TG)at admission time were higher(P<0.05),and fasting high-density lipoprotein-cholesterol(HDL-C)at admission time was lower in MS group than those in non-MS group(P<0.05).The incidence rate of HF was 25.09%(68/271)in AMI patients after PCI within 1 y,and incidence rate of HF was higher in MS group than that in non-MS group after PCI for 1 y(P<0.05).The percentages of cases with age≥65,diabetes history,hypertension history,Ⅲ/Ⅳ grades of Gensini grading,post-infarction arrhythmia and multi-vessel lesions,and preoperative levels of cardiac troponin T(cTnT),creatine kinase-MB isoenzyme(CK-MB)and high sensitivity C-reactive protein(hs-CRP)all were higher in patients with complicated HF than those in patients without complicated HF(P<0.05).The results of multi-factor Cox regression analysis showed that age≥65,hypertension history,Ⅲ/Ⅳ grades of Gensini grading,post-infarction arrhythmia,MS,multi-vessel lesions,and increases of preoperative levels of CK-MB and hs-CRP all were risk factors of HF in AMI patients after PCI(P<0.05).Conclusion The incidence rate of HF is higher in patients with AMI complicated by MS after PCI for 1y.MS,age≥65,hypertension history,Ⅲ/Ⅳ grades of Gensini grading,post-infarction arrhythmia,multi-vessel lesions,and increases of preoperative levels of CK-MB and hs-CRP are risk factors of HF in AMI patients after PCI.It is necessary to strengthen monitoring and implement personalized interventions for AMI patients with the above risk factors.