Clinical application evaluation of thrombus aspiration on emergency percutaneous coronary intervention of patients with ST-segment elevation type of myocardial infarction / 中国综合临床

ABSTRACT

Objective To investigate the influence of thrombus aspiration on ventricular remodeling of patients with ST?segment elevation type of myocardial infarction ( STEMI ) who underwent emergency percutaneous coronary intervention ( PCI) and its predicative value for patients′ prognosis. Methods Three hundred and eight patients who were diagnosed with STEMI line emergency PCI and hospitalized in the Cardiology Department of Jinghai Clinical College of Medical University of Tianjin from March 2011 to March 2014 were retrospective analyzed, including 152 patients received thrombus aspiration during primary PCI as thrombus aspiration group,and the remaining 156 patients without thrombus aspiration as control group. Indexes of myocardial perfusion levels such as ST?segment resolution 2 hours after PCI and TIMI myocardial perfusion grade were measured in all patients. All patients accepted echocardiography examinations to detect left ventricular end diastolic diameter(LVED) and left ventricular ejection fraction(LVEF) 10 days after PCI. The indexes differences of the two groups,secondary end points major cardiac adverse events(MACE) at 6 months were compared. Results There was no statistical difference between the ratio of two groups for ST segment fell more than 50%( 78. 9%( 120/152) vs. 71. 2%( 111/156) ,χ2=0. 428,P=0. 669) . But for ST segment fell more than 70%,the ratio of the thrombus aspiration group was significantly higher than that in the control group ( 73. 7%( 112/152 ) vs. 47. 4% ( 74/156 ) , χ2 = 4. 701, P = 0. 001 ) . Two groups of patients were treated by echocardiography 10 days after PCI,showed the LVED in the thrombus aspiration group was lower than that in the control group((50. 2±4. 7) mm vs. (51. 6±4. 6) mm,t=2. 642,P=0. 008),while the LVEF value was higher than that in the control group((56. 9±4. 9)% vs. (49. 4±4. 2)%,t=14. 434,P=0. 001). Recurrent angina pectoris decreased significantly in the thrombus aspiration group at 6 months ( 4. 61% ( 7/152 ) vs. 10. 90%(17/156),χ2=2. 056,P=0. 040). Conclusion STEMI patients adopt thrombus aspiration that undergoing emergency PCI,not only can improve myocardial reperfusion,especially microcirculation reperfusion, but also can improve the left ventricular systolic function and the prognosis of patients.