Abstract:

Objective To explore the influencing factors of myocardial microcirculation perfusion(MMP) disorder after percutaneous coronary intervention(PCI) in acute myocardial infarction(AMI) and its relationship with lactic acid. Methods Totally 132 patients undergoing PCI for AMI admitted to our hospital between February 2019 and July 2020 were selected, they were divided into the observation group (TMPG 0-2, poor MMP; n=56) and the control group (TMPG 3, good MMP; n=76) according to TIMI myocardial perfusion grading (TMPG), the data of two groups were collected, and binary logistic regression were used to analyze the influencing factors. ROC curve, lactic acid prediction, and Pearson method were used to analyze the correlation between lactic acid and the data, such as MMP, thrombolysis in myocardial infarction(TIMI), symptoms-to the first medical contact(FMC), FMC to heparin(FMC-H) administration, mojor adverse cardiovascular events(MACEs), history of diabetes, chronic slow flow(CSF), history of hypertension, history of smoking. Results The occurrence of MMP disorders in patients FMC-H>4 h, symptom-FMC>4 h, TIMI blood flow grade 0-2, MACEs, history of diabetes, CSF, history of hypertension, history of smoking were all independent factors that affected the occurrence of MMP disorders in patients(P<0.05). The accuracy, sensitivity and the specificity in predicting MMP by lactic acid was 93.94%, 91.10%, 96.10%, respectively. The lactic acid in observation group was higher than in the control group, FMC-H time and symptom-FMC time were longer than in the control group, and TIMI blood flow was lower than in the control group (P<0.05). The level of lactic acid was positively correlated with FMC-H time, symptom-FMC time, and negatively correlated with MMP, TIMI blood flow, MACEs, history of diabetes, CSF, history of hypertension, and smoking history. Conclusion MACEs, FMC-H time, FMC time, TIMI grade, chronic disease, and smoking history are all factors that affect MMP in patients undergoing PCI for AMI. Therefore, prevention and intervention are needed to reduce myocardial ischemia and reperfusion injury. Lactic acid can be used as an effective indicator to predict myocardial microcirculation perfusion status.

Key words: myocardial infarction, percutaneous coronary intervention, myocardial microcirculation perfusion, lactic acid