Effect of primary percutaneous transluminal coronary angioplasty and stent implantation on left ventricular remodeling and function in patients with acute myocardial infarction:compared with thrombolytic therapy / 中国介入心脏病学杂志

ABSTRACT

Objective To observe prospectively the changes of left ventricular size and function, and to evaluate the impact of primary percutaneous transluminal coronary angioplasty (p-PTCA) and stent implantation and thrombolytic therapy on left ventricular remodeling and function. Methods The patients with a first acute myocardial infarct and without contraindications to thrombolytic therapy were randomly assingned to p-PTCA group or urokinase (1?500?000 IU) therapy group within 12 hrs from the onset of symptoms or within 12～24 hrs if the evidence of myocardial ischemia in infarc zones was available. Two-demensional echocardaography were applied in the 2 nd , 12 th , and 24 th week after infarction, and major cardiac events were recorded. Results Sixty-five patients were enrolled (male 55, female 10, age 58.95?8.94 y). The patency of infarct related artery of 32 patients assigned to p-PTCA was 100%, while that of thrombolytic therapy group (33 patients) was 75.76%. The differences of end-systolic volume index (ESVI), end-diastolic volume index (EDVI), left ventricular ejection fraction (LVEF), and regional wall motion score index (RWMI) were significant statistically between p-PTCA group and thrombolytic therapy group ( P