Abstract
Objective To investigate the predictors of severe arrhythmia in patients with acute inferior wall myocardial infarction(IWMI)during hospitalization.Methods A total of 82 patients with acute IWMI were enrolled,and divided into an arrhythmia group(n=28)and a non-arrhythmia group(n=54)based on the occurrence of severe arrhythmia during hospitalization.Baseline characteristics,laboratory results,electrocardiogram(ECG),and coronary angiography indexes were collected from both groups.These data included sex,age,diabetes,hypertension,smoking history,Killip classification,time from symptom onset to hospital admission,systolic blood pressure and heart rate on admission,as well as serum potassium,fasting blood glucose(FBG),low-density lipoprotein cholesterol(LDL-C),neutrophil-to-lymphocyte ratio(NLR),troponin I,left ventricular ejection fraction(LVEF),Gensini score,presence of pathological Q waves,ST-segment elevation amplitude,QTc dispersion,right dominant coronary artery supply,and pre-procedural TIMI flow grade.The relationship between the above parameters and the occurrence of arrhythmia was analyzed.Results Univariate analysis revealed no statistically significant differences between the two groups in terms of sex,age,comorbidities(diabetes and hypertension),smoking history,time from symptom onset to hospital admission,heart rate on admission,LDL-C level,Gensini score,pathological Q waves,ST-segment elevation amplitude,or pre-procedural TIMI flow grade(all P>0.05).However,statistically significant differences were observed in Killip classification,systolic blood pressure on admission,serum potassium,FBG,NLR,troponin I,LVEF,QTc dispersion,and right dominant coronary artery supply(all P<0.05).Multivariate Logistic regression analysis identified Killip class(Ⅲ-Ⅳ),NLR≥5.0,QTc dispersion≥80 ms,and right dominant coronary artery supply as independent risk factors for severe arrhythmia(all P<0.05),while serum potassium≥3.8 mmol/L was an independent protective factor(P<0.05).Conclusion High Killip classification,elevated NLR,increased QTc dispersion,right dominant coronary artery supply,and low serum potassium level(<3.8 mmol/L)are strong independent predictors of severe arrhythmia in patients with acute IWMI.These factors facilitate early identification of high-risk patients and guide clinical intervention.关键词
急性下壁心肌梗死/心律失常/预测因素/QTc离散度/血钾Key words
acute inferior wall myocardial infarction/arrhythmia/predictor/QTc dispersion/serum potassium分类
医药卫生
