Correlation factors for major adverse cardiac and cerebrovascular events or hemorrhage in patients with acute ST-elevation myocardial infarction after primary percutaneous coronary intervention

AIM:To analyze correlation factors for major adverse cardiac and cerebrovascular events (MACCE) or hemorrhage in patients with acute ST-elevation myocardial infarction (STEMI) after primary percutaneous coronary intervention (PCI). METHODS: Two hundred and twenty-five cases of patients with STEMI in our department from September, 2008 to August 2010 were analyzed retrospectively. Patients with STEMI after PCI were divided into two groups: MACCE-hemorrhage group and non-MACCE or hemorrhage group, and the relationship between factors and MACCE-hemorrhage were analyzed by multivariate logistic regression. RESULTS: Patients in the MACCE-hemorrhage group had a higher proportion of direct stenting techniques and occurrence of slow or no-reflow and using intra-aortic balloon pump (IABP), number of all vessels with chronic total occlusion (CTO), maximum pre-expansion pressure, PT, CK, and age than in the non-MACCE or hemorrhage group (P<0.05 and P<0.01). However, patients in the MACCE-hemorrhage group had a lower proportion of tirofiban use, male patients, maximum pressure of stent expansion, TIMI class after slow or no-reflow treatment, number of all stents implanted, UA, TC, LDL-C, HDL-C, and LVEF than in the non-MACCE or hemorrhage group (P<0.05 and P<0.01). Multivariate logistic regression analysis showed that age, intracoronary use of tirofiban, and LVEF were correlative factors for MACCE-hemorrhage (P<0.05), and TIMI class after slow or no-reflow treatment was evidently a correlative factor for MACCE-hemorrhage (P<0.01). CONCLUSION: Older age, lower TIMI class after slow or no-reflow treatment and low LVEF are risk factors for MACCE-hemorrhage. Intracoronary use of tirofiban is a protective factor for MACCE-hemorrhage.