急性心肌梗死患者不同冠状动脉病变对介入术后预后的影响

Impact of different infarct coronary artery on prognosis of primary percutaneous coronary intervention for acute myocardial infarction

目的探讨急性心肌梗死经皮冠状动脉介入治疗患者不同冠状动脉病变对预后的影响。方法将117例接受急诊经皮冠状动脉介入治疗的急性心肌梗死患者根据罪犯血管不同分为左前降支组51例、左回旋支组27例、右冠状动脉组39例。比较3组患者术后ST段回落〉70％的梗死相关导联数、TIMI血流分级、住院期间及出院后1年内主要心脏不良事件发生率。结果与左回旋支组和右冠状动脉组比较，左前降支组术后ST段完全回落的梗死相关导联数和左室射血分数显著降低（P〈0．05），心源性死亡率及总主要心脏不良事件率显著升高（P〈0．05）。结论左前降支病变者术后心电图ST段回落更缓慢、左心功能不全更严重、主要心脏不良事件发生率更高、预后更差。

Objective To evaluate the impact of different infarct coronary artery on prognosis of primary percutaneous coronary intervention for acute myocardial infarction. Methods A total of 117 patients undergoing primary PCI for acute myocardial infarction were divided into three groups according to their different culprit vessel：Group left anterior descending（LAD） consisted of 51 patients, Group left cir- cumflex（LCX） included 27 patients and Group right coronary artery（RCA） included 39 patients. The number of ECG leads with ST-elevation resolusion（STR） 〉70% and TIMI flow grade after PCI were determined, and incidence of major adverse coronary events （MACE） during duration of hospital stay and oneear follow-up were also recorded. Results The number of ECG leads with STR 〉 70% after PCI and LVEF were significantly lower in Group LAD than those in Group LCX and RCA （P 〈 0.05 ）, the incidence of cardiac death and MACE were higher in Group LAD than those in Group LCX and RCA （ P 〈 0. 05 ）. Conclusions LAD infarction has been associated with poorer ST-segment resolution, greater left ventricular dysfunction and higher in