An analysis of risk factors for acute ST segment-elevation myocardial infarction with left ventricular aneurysm after primary percutaneous coronary intervention

Abstract:

Objective：To investigate the risk factors for acute ST segment elevation myocardial infarction（STEMI） with left ventricular aneurysm（LVA） after primary percutaneous coronary intervention（pPCI）. Methods：A total of 240 patients who were diagnosed with STEMI and underwent pPCI in our hospital form January 2017 to June 2018 were divided into LVA group（n=32） and non-LVA group（n=208） according to the presence or absence of LVA. A logistic regression model was established based on the basic information of the patients as well as their clinical data and auxiliary examination results to retrospectively analyze the risk factors for LVA. Results：The incidence of LVA gradually increased with the grade of total ischemic time（<6 h，6-12 h，>12 h）（χ2=12.40，P=0.000）. The multivariate logistic regression analysis showed that total ischemic time（OR=1.400，95%CI=1.163 to 1.687，P=0.000），heart rate（beats per minute，bpm） on admission（OR=1.054，95%CI＝1.011 to 1.099，P=0.014），Killip class ≥Ⅱ（OR=14.041，95%CI=3.131 to 62.970，P=0.001），≥4 adjacent leads with ST-segment elevation（OR=7.419，95%CI＝1.222 to 45.053，P=0.029），and final thrombol－ysis in myocardial infarction（TIMI） flow grade ≤2 after PCI（OR=12.034，95%CI=1.456 to 99.450，P=0.021） were the independent risk factors for LVA. However，previous angina pectoris was a protective factor against LVA（OR=0.066，95%CI=0.010 to 0.424，P=0.004）. Conclusion：Cardiovascular doctors should assess the risk of LVA in time. Achieving a TIMI flow grade 3 by pPCI may be important for preventing LVA.