The clinical prediction factors of nonculprit lesions progression in patients with acute ST elevation myocardial infarction after primary percutaneous coronary intervention

Abstract Objective :To investigate the relationship between the clinical features and progression of nonculprit lesions in patients with ST-elevation myocardial infarction (STEMI) after primary percutaneous coronary intervention (PPCI). Methods: A total of 192 patients (57.1 ± 9.2 years) with STEMI who underwent PPCI from January 2016 to December 2017 in Beijing Anzhen Hospital were enrolled in this study. All patients underwent PPCI as treatment for culprit lesions.Clinical and angiographic follow-up were performed in 12 months. All patients were divided into Nonculprit lesions(NCL) progression group ( 82 cases) and the control group (110 cases) according to angiographic follow-up outcome in 12 months. The clinical and angiographic features were analyzed. Results: Levels of body mass index（BMI）,serum creatinine（Scr）,fasting blood glucose（FBG）,glycated serum albumin（GSA）,glycated hemoglobin(GHb) and homocysteine (Hcy) in NCL progression group were significantly higher than those in the control group( P < 0. 05,respectively).Logistic regression showed that FBG( odds ratio = 1. 274,95% confidence interval: 1. 077-1. 505,P = 0. 005) and Scr ( odds ratio =1. 020,95% confidence interval:1. 002-1. 038,P=0. 027) were independent predictors of NCL progression.Partial correlation analysis showed that FBG was positively correlated with NCL progression( r = 0. 231,P = 0. 001) .Receiver operating characteristic(ROC) curve showed that the boundary point of FBG to predict NCL progression was 5. 715 mmol /L, the sensitivity was 74. 4% and the specificity was 46. 4%. Conclusion: FBG is an valuable predictor for NCL progression in patients with STEMI after PPCI.