术前静息心率对老年ST段抬高型心肌梗死患者经皮冠脉介入术治疗效果及预后的影响

目的 分析术前静息心率(RHR)对老年ST段抬高型心肌梗死(STEMI)患者经皮冠脉介入术(PCI)治疗的效果及预后的影响。方法 将2020年1月至2021年1月皖北煤电集团总医院间收治的211例老年STEMI患者纳为研究对象，根据其术前RHR水平，将其分为RHR1组(RHR:<60次/min,n=43)、RHR2组(RHR:60～79次/min,n=76)、RHR3组(RHR:80～99次/min,n=55)及RHR4组(RHR:≥100次/min,n=37)。比较各组病例资料，统计其PCI治疗后心肌梗死溶栓试验(TIMI)血流分级及心肌灌注分级，术后30 d及1年患者死亡及主要不良心血管事件(MACE)发生情况。采用SPSS 19.0软件进行数据分析。根据数据类型，组间比较分别采用t检验及χ²检验。采用Cox风险比例回归分析术前RHR水平与STEMI患者预后的关系。结果 不同静息心率水平组患者糖尿病病例占比、入院时收缩压、舒张压、低密度脂蛋白胆固醇、中性粒细胞计数、左心室射血分数≤40%病例占比、心肌梗死区域、血浆N末端B型利钠肽原水平比较，差异均有统计...

Impact of preoperative resting heart rate on therapeutic effect of percutaneous coronary intervention and prognosis in elderly patients with ST-segment elevation myocardial infarction

Objective To analyze the impact of preoperative resting heart rate (RHR) on the efficacy of percutaneous coronary intervention (PCI) and prognosis in the elderly patients with ST-segment elevation myocardial infarction (STEMI). Methods A total of 211 elderly STEMI patients admitted to the Wanbei Coal-Electricity Group General Hospital between January 2020 and January 2021 were included as the study subjects. According to the preoperative RHR level, the patients were divided into RHR1 group (RHR<60 times/min; n=43), RHR2 group (RHR:60-79 times/min; n=76), RHR3 group (RHR:80-99 times/min; n=55) and RHR4 group (RHR≥100 times/min; n=37). The case data of each group were compared. Blood flow grading and myocardial perfusion grading of Thrombolysis in Myocardial Infarction (TIMI) after PCI were recorded, and deaths and major adverse cardiovascular events (MACE) at 30 days and 1 year after PCI were counted. SPSS 19.0 was used for statistical analysis. Data comparison between two groups was preformed using t test orχ² test depending on data type. Cox proportional hazard regression was employed to analyze the relationship between preoperative RHR level and prognosis in the STEMI patients. Results There were statistically significant differences among RHR groups in the proportion of diabetic cases, systolic blood pressure, diastolic blood pressure, low-density lipoprotein cholesterol and neutrophil count at admission, proportion of cases with left ventricular ejection fraction ≤40%, myocardial infarction area and plasma N-terminal pro-B-type natriuretic peptide (P<0.05). There were statistically significant differences among RHR groups in TIMI blood flow grades and myocardial perfusion grades (P<0.05). There were statistically significant differences in the incidence rate of MACE and death rate within 30 days after PCI and at one year after PCI among RHR groups (P<0.05). Multivariate Cox proportional hazard regression analysis suggested that preoperative RHR≥100 beats/min was a risk factor for death (RR=3.985; P<0.001) and MACE (RR=6.091; P=0.013) within 30 days after PCI in the STEMI patients, and that preoperative RHR≥100 beats/min was a risk factor for death (RR=2.744; P<0.001) and MACE (RR=3.114; P<0.001) in STEMI patients at one year after PCI. Conclusion Preoperative RHR≥100 times/min will increase the risk of death and MACE in STEMI patients after PCI.