关键词: 心肌梗死；冠状动脉介入治疗；血脂水平；预后

Abstract:

Abstract:Objective To evaluate the correlation between the lipid level of ST segment elevation myocardial infarction (STEMI) patients after treated with percutaneous coronary intervention(PCI) for 1 year and to clarify the relationship between lipid level and prognosis. Methods Based on the LDL-C level within 24 h after admission,624 patients with STEMI underwent primary PCI were divided into  normal group (LDL-C＜3.37 mmol/L,n=380),LDL-C marginal increased group (LDL-C 3.37-4.14 mmol/L,n=159) and LDL-C increased group(LDL-C＞4.14 mmol/L,n=85). Of these 624 patients,the serum lipid levels of 335 patients after statins treatment for 4 weeks after discharged were collected underwent follow-up in outpatient settings,and these 335 patients were divided into target group (LDL-C＜1.81 mmol/L,n=77) and non-target group (LDL-C≥1.81 mmol/L,n=258 ).The relationship between the lipid level of acute period and  MACCE prognosis after  treatment was studied.  Results The occurrence rate of MACCE(cardiac death,ischemic stroke and recurrent myocardial infarction and composite events) had no significant differences between three groups(P>0.05). After statins treatment,the target group got one MACCE patients(1.3%),which was significantly lower than that in non-target group(7.4%)(P<0.05). Logistic regression analysis showed a significant relationship between the triglyceride (TG) level at acute stage and ischemic stroke (OR=1.226；95% CI：1.068-1.407;P<0.05 ),so did the LDL-C level after statins treatment and MACCE (OR=1.788；95% CI：1.091-5.233；P<0.05). Smoking history (OR=0.136；95% CI：0.016-0.115；P<0.05) and higher SYNTAX score (OR=1.544；95% CI：5.387-33.522；P<0.05) were also influence factors of MACCE. Conclusion The different levels of LDL-C of  patients at acute stage are not related with MACCE,but it is related with the MACCE of the patients with unnormal LDL-C level after statins treatment.

Key words: myocardial infarction;percutaneous coronary intervention;blood lipid level;prognosis