Influence of dexmedetomidine on coronary artery and myocardial protection in AMI patients undergoing PCI / 心血管康复医学杂志

ABSTRACT

Objective:To explore influence of dexmedetomidine (DEX) on coronary artery diameter and myocardial protection in patients with AMI undergoing PCI .Methods:A total of 92 AMI patients ,who received PCI in our hospital from Mar 2016 to Mar 2017 ,were selected .Patients were randomly and equally divided into routine PCI group and DEX group (received DEX intravenous pump based on routine PCI group ).Coronary artery diameter , HR ,SBP ,DBP ,serum levels of cardiac troponin I (cTnI) ,heart type fatty acid-binding protein (H-FABP) and creatine kinase isoenzyme MB (CK-MB) before ,6h and 24h after treatment ,and incidence of adverse reactions were observed and compared between two groups .Results:Compared with routine PCI group ,on 6h and 24h after treatment ,there were significant reductions in coronary artery diameter [24h (2.68 ± 0.36) mm vs .(2.44 ± 0.35) mm] , HR [24h(86.56 ± 8.12) beats/min vs .(75.42 ± 7.05) beats/min] ,DBP [24h(76.26 ± 10.30) mmHgvs.(68.28 ± 9.25) mmHg] and SBP [24h(133.17 ± 23.76) mmHg vs.(118.28 ± 10.26) mmHg] in DEX group , P＜0. 01 all.Compared with before treatment group ,there were significant rise respectively in serum levels of cTnI and CK-MB in two groups on 6h and 24h after treatment ,and serum H-FABP levels significantly decreased respectively , P＝0.001 all.Compared with routine PCI group ,on 6h and 24h after treatment ,there were signifi-cant rise in serum levels of cTnI [24h(1.23 ± 0.05) ng/mlvs.(1.64 ± 0.07) ng/ml] and CK-MB [24h (125.09 ± 13.16) μg/ml vs.(149.71 ± 14.53) μg/ml] ,and significant reduction in serum H-FABP level [24h (10.44 ± 2.59) ng/ml vs.(8.31 ± 2.16) ng/ml] in DEX group , P＝0.001 all.Incidence rate of adverse reactions in DEX group was significantly lower than that of routine PCI group (6.52% vs.23.91%) , P＝0. 020. Conclusion: Though dexmedetomidine can constrict coronary artery ,but it can perform myocardial protection through reducing blood pressure and HR etc .in AMI patients undergoing PCI ,and its adverse reactions are few ,which is worth extending .