[Analysis of factors correlated to death and reinfarction in patients with acute myocardial infarction].

Objective: To identify the predictors of death and reinfarction in patients with acute myocardial infarction (AMI) treated with urokinase (UK) thrombolysis or percutaneous transluminal coronary angioplasty (PTCA).

Methods: In ambispective cohort study, 97 cases of AMI were treated with UK thrombolytic therapy, while 93 cases of AMI were treated with PTCA. The patients' data about clinical outcome during hospital and follow-up periods were collected. Death and reinfarction were defined as adverse event. To analyze the correlative factors and independent predictors of death and reinfarction, the spearman rank correlation and multivariate logistic regression modeling were performed.

Results: During hospital,incidences of adverse event were 15.46 percent and 6.45 percent in UK and PTCA groups respectively. In follow-up period, they were 30.93 percent and 9.68 percent respectively. Age, Q wave leads, Kill ip class, heart failure in hospital, the history of hypertension and myocardial infarction were positive correlation with adverse event, whereas history of smoking, systolic blood pressure and ejection fraction (EF) showed negative correlation with the adverse event. The interventional therapy, associated with lower mortality and reinfarction rate, was the independent predictor for adverse event in UK and PTCA groups during hospital and follow-up periods. Furthermore, it was the only independent predictor for PTCA group. In UK group, the adverse event also was independently predicted by age, heart failure and Q wave leads in hospital and by age, heart failure during follow-up period. There was negative correlation between preinfarction angina and adverse event, and positive correlation between thrombolysis and adverse event inpatients undergone rescue PTCA.

Conclusion: Interventional therapy is crucial independent predictor for adverse event of patients suffering from AMI. The adverse event is also predicted by age, Q wave leads and heart failure. The history of preinfarction angina is negative correlation with the adverse event in hospital, due to, maybe, myocardium ischemia preconditioning.