Effect of coronary revascularization on the prognosis of acute myocardial infarction patients complicated with heart failure
10.3760/cma.j.issn.1671-0282.2013.01.012
- VernacularTitle:血运重建治疗对合并心力衰竭的急性心肌梗死患者预后的影响
- Author:
Zengming XUE
;
Juhui AN
;
Zhigang ZHAO
;
Xiao WANG
;
Shaoping NIE
;
Changsheng MA
- Publication Type:Journal Article
- Keywords:
Revascualrization;
Acute myocardial infarction;
Heart failure;
Prognosis
- From:
Chinese Journal of Emergency Medicine
2013;(1):50-56
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the clinical characteristics and prognosis of the patients of acute myocardial infarction complicated with heart failure by analyzing the prognostic factors of these patients.Methods This was a single-center prospective study of 349 patients with acute heart failure and ECG documented acute ST elevated myocardial infarction.All patients were treated with primary PCI.After PCI,clinical,angiographic and ECG characteristics,and prognosis of those with preserved (≥50％) or reduced (＜ 50％) left ventricular ejection fraction (LVEF) were assessed.Heart failure patients were divided into two groups:124 with reduced EF (HFREF) and 225 with preserved EF (HFPEF).After 367 days of average follow-up,the primary outcome and number of death were recorded.Results Of them,4 (1.8％) patients in the HFPEF group vs.6 (4.8％) in the HFREF group died.The difference in rate of death between two groups was not significant (P =0.314).There were significant difference in main adverse cardiac and cerebra vascular events (MACCE) occurred during follow-up period between the two groups (P =0.022).The Killip Classification of heart failure (HR =1.092,95％ CI 1.040 ～ 1.149,P ＜0.01) was significantly related to the death rate during follow-up.Conclusions The independent factors affecting prognosis in patients with acute heart failure after coronary revascularization were closely consistent with the stratums of the Killip Classification.Patients with HFPEF had a similar prognosis as those with HFREF after primary stenting.
