Delayed percutaneous coronary intervention versus conservative strategy after thrombolysis for ST-segment elevation myocardial infarction / 中国介入心脏病学杂志

ABSTRACT

Objective To evaluate the role of routine delayed percutaneous coronary intervention (PCI) after thrombosis in the management of patients with ST-segment elevation myocardial infarction. Methods Ninety-eight patients with STEMI who underwent routine delayed PCI after thrombosis and other 82 patients with STEMI who were given conservative strategy after thrombolysis were enrolled in this study and were investigated during their in-hospital period and 6-month follow-up regarding major adverse clinical events (MACE) and the cardiac structure and function by echocardiography. The patients were divided into the control group (conservative strategy after thrombolysis), therapy group 1 (routine delayed PCI after successful thrombolysis), and therapy group 2 (routine delayed PCI after unsuccessful thrombolysis). Results Compared with conservative strategy after thrombolysis, routine delayed PCI after thrombosis decreased in-hospital mortality (4.9% vs 0%, 0%), shortened average hospital stay (25.3 days vs 13.5 days, 15.1days), decreased the need for revascularization for target lesion (7.3% vs 0%, 0%) and lowered the incidence of thrombosis or infarction (7.3% vs 0%, 0%), and also produced lower mortality (13.4% vs 1.4%, 0%), prevented reinfarction (12.2% vs 4.2%, 4.5%) and stroke (2.4% vs 0%, 0%), decreased the need for revascularization for target lesion (28% vs 4.2%, 4.5%) and prevented further left ventricle remodling. Conclusion Routine delayed PCI after thrombosis may to prevent recurrent ischemia, reinfarction, and reocclusion, so as to improve immediate results and 6-month prognosis.