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Objective To evaluate the predictors of the occurrence of intramyocardial hemorrhage (IMH) in patients with acute ST-segment elevation myocardial infarction (STEMI) after primary percutaneous coronary intervention. Methods A total of two hundred and four patients, admitted in the First Medical Center of Chinese PLA General Hospital from February, 2014 to March, 2019, diagnosed as STEMI undergoing emergency PCI treatment within the first 12 h of evolution, were screened for our retrospective analysis. IMH lesions were visualized by T2-weighted sequences on cardiac magnetic resonance (CMR) between days 3 to 7 after PCI. Based on the existence of IMH, all patients were classified into the non-IMH group (n=117) and the IMH group (n=87). We investigate the clinical features between the two groups. Factors influencing were analyzed by logistic regression analysis. Results Compared with the non-IMH group, the ischemia time, admission glucose, admission heart rate, hemoglobin(Hb) reduction, creatine kinase isoenzymes (CK-MB) peak value, troponin T (TnT) peak value, low-density lipoprotein cholesterol, infarct size were significantly higher and the left ventricular ejection fraction (LVEF) was significantly lower in IMH group(P<0.05). Besides, in the IMH group, the proportion of patients with diabetes mellitus history, hyperlipemia history, preprocedural thrombolysis in myocardial infarction (TIMI) flow grades <3, anterior infarction, periprocedural glycoprotein Ⅱb/Ⅲa inhibitor treatment was significantly higher (P<0.05). Logistic regression model presented that diabetes mellitus history (P=0.003, OR=7.782,95%CI 2.009-30.846), ischemia time (P<0.001, OR=1.011, 95%CI 1.007-1.014), admission glucose (P<0.001, OR=1.428, 95%CI 1.182-1.725), admission heart rate (P=0.006, OR=1.041, 95%CI 1.012-1.071), Hb reduction (P<0.001, OR=1.117, 95%CI 1.059-1.178), CK-MB peak value (P=0.007, OR=1.006, 95%CI 1.002-1.010), anterior infarction (P=0.042, OR=2.626, 95%CI 1.037-6.652) and periprocedural glycoprotein Ⅱb/Ⅲa inhibitor treatment (P=0.022, OR=3.362, 95%CI 1.195-9.460) were independent risk factors for IMH in acute STEMI patients undergoing PCI. Conclusion Diabetes mellitus history, ischemia time, admission glucose, admission heart rate, Hb reduction, CK-MB peak value, anterior infarction, periprocedural glycoprotein Ⅱb/Ⅲa inhibitor treatment were independent risk factors for IMH in the patients with acute STEMI undergoing primary PCI. Appropriate strategies for managing acute STEMI patients at high risk for IMH should be taken into consideration.
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| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |
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