急性心肌梗死患者PCI术后并发心房颤动的危险因素

Risk Factors of Atrial Fibrillation After PCI in Patients with Acute Myocardial Infarction

目的探讨急性心肌梗死(AMI)患者行经皮冠状动脉介入术(PCI)后并发心房颤动情况及其危险因素。方法对郑州大学附属郑州中心医院2020年6月至2022年6月收治的120例AMI患者临床资料进行回顾性分析,根据是否并发心房颤动将其分入观察组(新发心房颤动,54例)与对照组(非新发心房颤动,66例)。比较两组患者冠状动脉造影、介入治疗结果、Syntax积分等指标。采用多因素logistic回归分析探讨AMI患者PCI术后新发心房颤动危险因素。结果观察组患者年龄高于对照组,吸烟史、高血压、冠心病和肾功能不全患者占比高于对照组(P<0.05)。观察组左心房内径大于对照组,心肌肌钙蛋白I水平高于对照组(P<0.05)。观察组双支、3支及以上病变血管数量比率高于对照组,且观察组Syntax积分高于对照组(P<0.05)。多因素logistic分析显示,年龄、肾功能不全、Syntax积分、左心房内径是AMI患者心房颤动危险因素(P<0.05)。结论AMI患者PCI术后存在一定程度的新发心房颤动,新发心房颤动的发生与年龄、肾功能不全、Syntax积分、左心房内径密切相关。

Objective To investigate the risk factors after percutaneous coronary intervention(PCI)in patients with acute myocardial infarction(AMI).Methods The clinical data of 120 patients with AMI admitted to Zhengzhou Central Hospital Affiliated to Zhengzhou University from June 2020 to June 2022 were retrospectively analyzed,and they were divided into observation group(54 cases with new atrial fibrillation)and control group(66 cases with non-new atrial fibrillation)according to whether they were complicated with atrial fibrillation.The two groups were compared in terms of syntax scores,interventional therapy outcomes,and coronary angiography.The risk variables for developing atrial fibrillation in patients with AMI following PCI were examined using multivariate logistic regression analysis.Results The age of patients in observation group was higher than that in control group,and the proportion of patients with smoking history,hypertension,coronary heart disease and renal insufficiency were higher than those in control group(P<0.05).The left atrial diameter and cardiac troponin I level of observation group were higher than control group(P<0.05).The proportion of two,three or more vessels in observation group were higher than those in control group,and the Syntax score in observation group was higher than that in control group(P<0.05).Multivariate logistic analysis showed that age,renal insufficiency,Syntax score and left atrial diameter were risk factors for atrial fibrillation in AMI patients(P<0.05).Conclusion There is a certain degree of new atrial fibrillation in AMI patients after PCI,and the occurrence of new atrial fibrillation is closely related to age,renal insufficiency,Syntax score and left atrial diameter.