Correlation Factors for Left Ventricular Dysfunction of Acute ST Segment Elevation Anterior Myocardial Infarction After Primary Percutaneous Coronary Intervention With Thrombolysis in Myocardial Infarction 3 Grade

Objective:To elucidate the relative factors to left ventricular dysfunction of acute ST segment elevation anterior myocardial infarction(STEMI)after primary percutaneous coronary intervention(PCI)with thrombolysis in myocardial infarction 3 grade(TIMI). Methods: A total of 112 patients with acute ST segment elevation anterior myocardial infarction after PCI were analyzed. 52 patients with anterior myocardial infarction were defined as left ventricular dysfunction group; and Control group contained 60 patients of anterior myocardial infarction with coronary antergrade flow TIMI 3 class, after primary PCI, the patients’ left ventricular function recovered to normal. Multiple logistic regression analysis was used to identify the independent correlation factors of left ventricular dysfunction. Results: The occurrence of left ventricular dysfunction was 19%. Univariate analysis showed that diabetes mellitus, symptom onset to reflow time, pre-infarction angina, thrombolysis in myocardial infarction myocardial blush grade(TMBG), wall motion score(WMS)and wall motion score index(WMSI)were related to left ventricular dysfunction(P=0.049). However, multiple logistic regression analysis indicated that pre-infarction angina, TMBG, WMS and WMSI were the correlation factors of left ventricular dysfunction(P=0.040). Conclusion: With patients recovering blood flow TIMI 3 grade after primary PCI, lower TMBG, severe micro vascular injury and abnormal wall motion could promote left ventricular dysfunction. Pre-infarction angina might improve micro vascular function and therefore attenuated left ventricular dysfunction. However, the risk factors for coronary heart disease had no correlation with left ventricular dysfunction.