Tianjin Medical Journal ›› 2022, Vol. 50 ›› Issue (3): 314-318.doi: 10.11958/20212269

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Risk factors of early high-risk ventricular arrhythmia in patients with STEMI

ZHA Shuangying, FENG Liuliu, LIU Tianhua, HUANG Hongman   

  1. 1 Department of Heart Special Inspection, 2 Department of Cardiovascular Medicine, Shanghai Shidong Hospital, Shanghai 200438, China
  • Received:2021-10-09 Revised:2021-12-17 Published:2022-03-15 Online:2022-03-15

Abstract: Objective To analyze the risk factors of early high-risk ventricular arrhythmia (HRVA) in patients with acute ST-segment elevation myocardial infarction (STEMI). Methods Totally 164 patients with STEMI treated by emergency percutaneous coronary intervention (PCI) in the hospital were selected. According to the presence or absence of HRVA after operation, patients enrolled were divided into the HRVA group (n=31) and the non-HRVA group (n=133). Clinical data of the patients were collected, and Logistic regression analysis was performed to screen the risk factors of HRVA. Receiver operating characteristic (ROC) curve was used to analyze the predictive value of these indicators. Results The proportion of patients with Killip grade Ⅲ-Ⅳ, T-peak end interval (Tpe) and corrected QT interval (QTc) were higher/longer in the HRVA group than those in the non-HRVA group (P<0.05). Killip grade Ⅲ-Ⅳ, long Tpe and long QTc were independent risk factors for HRVA (P<0.05). ROC analysis showed that the area under the curve (AUC) values and 95%CI of HRVA predicted by Killip classification, Tpe, QTc and their combination were 0.708 (0.592-0.824), 0.718 (0.614-0.822), 0.670 (0.562-0.777) and 0.843 (0.757-0.928), respectively. The prediction sensitivity and specificity of the three in combination were 74.21% and 88.01%. Conclusion Killip grade Ⅲ-Ⅳ, high Tpe and high QTc are main risk factors of early HRVA in patients with STEMI. Combination of the three can achieve good predictive performance for HRVA.

Key words: ST elevation myocardial infarction, percutaneous coronary intervention, arrhythmias, cardiac, acute disease, root cause analysis, prognosis