The effect of different treatment methods in patients of acute myocardial infarction with emergency percutaneous coronary intervention

Abstract

Objective To explore the effect of different treatment methods in patients of acute ST-segment elevation myocardial infarction (STEMI) with emergency percutaneous coronary intervention (PCI).Methods Sixty-seven patients with high blood clots load in infarction related artery (IRA) and performed emergent PCI because of STEMI from August 2012 to October 2013 were enrolled.They were divided into treatment group (intravenous tirofiban,PCI boc thrombus suction,tirofiban injection via thrombus suction catheter coronary artery injection,35 cases) and control group (PCI simple,intravenous tirofiban,32 cases).The myocardial dyeing classification (MBG) with postoperative criminal vascular,ST-segment elevation resolution (STR) ≥50％ in electrocardiogram after 1.5 h treatment and the changes of left ventricular ejection fraction (LVEF) and left ventricular end-diastolic diameter (LVEDd) after 2 weeks and 3 months treatment were observed in two groups.The bleeding rate and incidence of major adverse cardiac events (MACE) were compared between two groups.Results The ratio of MBG 2-3 grade of postoperative criminal vascular in treatment group was more than that in control group [60.0％ (21/35) vs.43.8％(14/32)],and there was significant difference (P＜ 0.05).The ratio of STR≥50％ in electrocardiogram after 1.5 h treatment in treatment group was higher than that in control group [71.4％(25/35) vs.46.9％ (15/32)],and there was significant difference(P ＜ 0.05).There was no significant difference in LVEDd after 2 weeks treatment between two groups (P ＞ 0.05),but LVEF in treatment group was higher than that in control group [(54.2 ± 5.7)％ vs.(44.7 ± 6.1)％],and there was significant difference (P ＜ 0.05).LVEDd after 3 months treatment in treatment group was less than that in control group [(46.5 ±4.9) mm vs.(57.1 ± 5.3) mm] and LVEF in treatment group was higher than that in control group [(60.5 ± 4.5)％ vs.(43.6 ± 5.7)％],and there was significant difference (P＜ 0.05).There was no significant difference in the bleeding rate and incidence of MACE between two groups (P ＞ 0.05).Conclusion Thrombosis suction and tirofiban injection through the suction catheter into coronary artery can increase the level of myocardial perfusion,reduce myocardial injury and improve the prognosis in the near future. Key words: Myocardial infarction;  Angioplasty; balloon;  coronary;  Thrombus aspiration;  Tirofiban