Effect of percutaneous coronary intervention elective surgery and emergency surgery on clinical outcomes in patients with acute myocardial infarction

Abstract

Objective To evaluate the efficacy and safety of different percutaneous coronary intervention (PCI) surgery in patients with acute myocardial infarction. Methods A total of 156 patients with acute myocardial infarction who were treated in the People’s Hospital of Linfen from February 2017 to August 2018 were enrolled. The 156 patients were grouped according to the visit time of the patients, the patients who had onset until the time of treatment for more than 24 hours were selected as elective surgery group (elective group, n=62), the patients with onset to treatment time between 12 to 24 hours were treated as emergency surgery group (emergency group, n=86). According to the Guidelines for the Treatment of Percutaneous Coronary Interventions in China (2016) , the patients in the elective surgery group and the emergency surgery group were treated with elective and emergency PCI. Left ventricular systolic and left ventricular remodeling parameters, namely left ventricular end-systolic volume (LVESV), and left ventricular ejection fraction (LVEF)were compared before and after treatment, and the immediate success rate was compared between the two groups. The 156 patients were followed up for 3 months, and the incidence of cardiovascular events during hospitalization and follow-up was recorded and compared. Results After 1 month of treatment, the LVESV and LVEF were significantly improved in both groups (P all<0.05). The LVESV and LVEF indexes in the emergency surgery group were significantly improved compared with the elective surgery group after 1 month (P all<0.05). The immediate success rate of the emergency surgery group was significantly higher than that of the elective surgery group (96.5% vs. 87.1%, χ2=4.642, P=0.031). The incidence of cardiovascular events during the hospitalization and follow-up period was significantly lower in the elective surgery group than that in the emergency surgery group (P=0.003, 0.008). Conclusions Different operation timings of PCI for patients with myocardial infarction have a great influence on myocardial improvement, incidence of cardiac events and clinical efficacy. The patients undergoing emergency PCI during the onset of myocardial infarction to PCI between 12 and 24 hours can significantly alleviate the myocardial ischemia, reduce the incidence of cardiac events, and improve clinical outcomes. Key words: Acute myocardial infarction; Percutaneous coronary intervention; Elective surgery; Emergency surgery