Early clinical prediction of coronary microcirculation disturbance after emergency percutaneous coronary intervention in patients with acute myocardial infarction
- VernacularTitle:急性心肌梗死患者急诊经皮冠状动脉介入治疗术后发生冠状动脉微循环障碍的早期临床预测技术研究
- Author:
Li WANG
1
;
Chunyuan WU
;
Long KUANG
;
Jiaxian SONG
;
Cheng REN
;
Fang XU
Author Information
- Keywords: left ventricular global longitudinal strain; myocardial contrast echocardiography; global register of acute coronary events; acute myocardial infarction; coronary microcirculation disorder
- From: Journal of Clinical Medicine in Practice 2024;28(3):39-44,50
- CountryChina
- Language:Chinese
- Abstract: Objective To investigate the clinical value of left ventricular global longitudinal strain(LVGLS)combined with the global register of acute coronary events(GRACE)score in predic-ting coronary microcirculation disorder(CMD)in patients with acute myocardial infarction(AMI)af-ter emergency percutaneous coronary intervention(PCI).Methods A total of 90 patients with AMI were selected as the study objects(10 cases were lost in follow-up,4 cases were screened for poor im-age quality),and 76 cases were finally included.Left ventricular myocardial contrast echocardio-graphy(MCE)was performed in patients at 48 h after surgery.Patients were divided into non-CMD group(n=53)and CMD group(n=23)according to coronary microcirculation perfusion.Clinical data and echocardiographic data of the two groups were analyzed and compared.Multivariate Logistic regression analysis was used to screen the influencing factors of CMD occurrence,and receiver operat-ing characteristic(ROC)curve was drawn to analyze its clinical predictive value.Results Of the 76 patients,23(30.3％)cases had CMD.LVGLS and GRACE scores in the CMD group were higher than those in the non-CMD group,and the differences were statistically significant(P＜0.05).Multi-variate Logistic regression analysis showed that LVGLS and GRACE score were independent predictors of CMD in AMI patients after emergency PCI.The area under the curve of CMD predicted by LVGLS was 0.858(95％CI,0.769 to 0.948).LVGLS combined with GRACE predicted that the area un-der the curve for CMD was 0.891(95％CI,0.815 to 0.967).Conclusion LVGLS is an inde-pendent predictor for early assessment of CMD occurrence in AMI patients after emergency PCI,and its combination with GRACE score can improve the accuracy of predicting CMD occurrence.
