Clinical assessment for the long-term benefits of delayed percutaneous transluminal coronary intervention in patients with acute myocardial infarction / 中国介入心脏病学杂志

ABSTRACT

Objective To compare the long term outcomes of delayed or primary percutaneous transluminal coronary intervention(PCI) with concervative drug therapy for acute myocardial infarction(AMI).Methods The data of 276 patients with AMI hospitalized during January 1996 to October 2003 were analyzed retrospectively.The patients were divided into three groups including primary PCI group(75 cases underwent primary PCI within 12 hours of symptom onset),delayed PCI group(73 cases underwent delayed PCI after 24 hours symptom onset) and conservative drug therapy group(128 cases without PCI treatment).Major adverse cardiac events(MACE) were recorded during the follow-up period(mean 4.3?2.7 years).Echocardiography was carried out and long-term mortality rate was recorded during follow-up.Results The Baseline characteristics of the three groups were similar except elevation in ST segment and in-hospital duration which were significantly different in the primary PCI group.The percentage of follow-up completion was 89.5%(247/276).The in-hospital mortality of the conservative therapy group was higher than both PCI groups.The LVEF of the delayed PCI group,primary PCI group and the conservation therapy group were 57.4%?3.4%,59.3%?7.5% and 54.7%?4.1% respectively.There was 1 deceased case in both the delayed and primary PCI group but 14 cases in the conservative group.There was no significant difference between the two PCI groups in terms of combined end point of death and clinical events different.Conclusion Compared with conservative drug therapy,delayed PCI can further improve the long-term prognosis of STEMI patients.