Practical Geriatrics ›› 2022, Vol. 36 ›› Issue (3): 257-260.doi: 10.3969/j.issn.1003-9198.2022.03.011

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Prediction value of left ventricular end-diastolic pressure combined with ankle-brachial index for no-reflow and prognosis in patients with acute myocardial infarction after percutaneous coronary intervention

LI Sheng, LIU Ying-feng, YU Jia-feng, LI Zhi-cong, ZHAO Xin, MIAO Fei   

  1. Department of Cardiovascular Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou 510280, China
  • Received:2021-04-26 Online:2022-03-20 Published:2022-03-29

Abstract: Objective To explore the predictive value of left ventricular end diastolic pressure (LVEDP) combined with ankle-brachial index (ABI) on no-reflow and prognosis in the elderly patients receiving percutaneous coronary intervention (PCI) for acute myocardial infarction(AMI). Methods A total of 280 patients with AMI admitted in our hospital from January 2017 to December 2018 were divided into normal group and no-reflow group according to the occurrence of reflow during the operation. The clinical data, the levels of LVEDP and ABI were compared between the two groups, and Logistic regression was used to analyze the risk factors of no-reflow. The patients were followed up for one year after PCI, and the incidence of major adverse cardiovascular events (MACE) was recorded and compared. The prediction value of LVEDP and ABI was analyzed by receiver operating characteristic (ROC) curve. Results The levels of LVEDP and B-type natriuretic peptide (BNP), the proportion of Killip grades Ⅲ-Ⅳ, the peak of creatine kinase isoenzyme in no-reflow group were significantly higher than those in normal group (P<0.05), and the levels of left ventricular ejection fraction (LVEF) and ABI were significantly lower than those in normal group (P<0.001). Logistic regression analysis showed that Killip classification of cardiac function, LVEDP, BNP and ABI were independent risk factors of no-reflow during PCI (P<0.05). After 1 year of follow-up, all-cause mortality (4.33% vs 11.11%) and total MACE incidence rate (16.83% vs 34.72%) in normal group were significantly lower than those in no-reflow group (P<0.05). The area under the ROC curve (AUC) of LVEDP combined with ABI predicting MACE was significantly higher than LVEDP and ABI alone (P<0.05). Conclusions LVEDP and ABI are the independent risk factors for no-reflow of AMI through PCI intervention. The combined detection shows potential application value for the prognosis prediction.

Key words: left ventricular end diastolic pressure, ankle-brachial index, acute myocardial infarction, no-reflow, prognosis

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