Abstract
OBJECTIVE: To investigate the effects of complete revascularization on oxidative stress, blood pressure control, and prognosis in patients with acute myocardial infarction (AMI). METHODS: Clinical data from 80 AMI patients were retrospectively analyzed. Based on the SYNTAX Revascularization Index (SRI), patients were classified into the complete revascularization group (SRI=100%, n=31), partial revascularization group (SRI 50-99%, n=27), and low revascularization group (SRI<50%, n=22). Postoperative oxidative stress markers (malondialdehyde, MDA; angiotensin converting enzyme, ACE; and superoxide dismutase, SOD), myocardial injury marker (cardiac Troponin I, cTnI), and ambulatory blood pressure parameters were compared among groups. Their correlations were analyzed, and the predictive value of SRI for major adverse cardiovascular events (MACE) was evaluated. RESULTS: One month after surgery, the complete revascularization group exhibited significantly lower MDA than the partial and low revascularization groups, higher SOD, and lower ACE and cTnI levels (all P<0.001). Six months postoperatively, the complete revascularization group showed improvements in 24 h SBP, 24 h SBP-SD and nocturnal blood pressure decline rate (all P<0.01). The incidence of MACE was significantly lower in the complete revascularization group (6.45% vs. 36.73%, P=0.002). Logistic regression showed that SRI was an independent protective factor for MACE (OR=0.119, 95% CI: 0.025-0.557, P=0.007). ROC curve analysis indicated its predictive value for MACE with an AUC of 0.835 and an optimal cut-off value of 69.360%. CONCLUSION: Complete revascularization improves blood pressure stability and reduces MACE risk in AMI patients by alleviating oxidative stress. Achieving an SRI above 69.360% can be considered a clinical target.