The Effects Of Ligustrazine On Myocardium Perfusion In Patients With Acute ST Segment Elevation Myocardial Infarction After Emergency Percutaneous Coronary Intervention

Objective To explore the effects of Liqustrazine on myocardium perfusion in patientswith acute ST segment elevation myocardial infarction (STEMI) after emergency percutaneous coronary intervention (PCI).Methods All patients received successful PCI (Thrombolysis in Myocardial Infarctionflow grade 2 or 3)within 12 hours after the symptom onset and Single-photon emission computed temography (SPECT) was performed immediately after PCI, and repeated 4 hours and 15 days later. Forty-one patients with first STEMI who had >3 of myocardial perfusion defect score in SPECT shortly after PCI were randomly assigned to Liqustrazine group (n=20, 320mg/day of Liqustrazine for 15 days) or control group (n=21). All patients underwent electrocardiography (ECG) before PCI, and repeated 4 hours and 15 days after PCI. The activity of CK(creatine kinase) and CK-MB(creatine kinase-MB isoenzyme) was mearsured every 2 hours for 24 hours , and every 6 hours for 72 hours.Results (1) There was no significant differrence of total myocardial perfusion defectscore immediately after PCI between the two groups(P>0.05), while the patients in control group had a higher total myocardial perfusion defect score than those in Liqustrazine group 4 hours later ( p <0.05). There was no significant different change of myocardial perfusion defect score or LVEF (left ventricular ejection fraction) between the two groups from 4 hours to 15 days after PCI (P>0.05). LVEDV(left ventricular end-diastolic volume) and LVESV(left ventricular end-systolic volume) of Liqustrazine group were improved 15 days after PCI (p <0.05), but no significant difference between the two groups 4 hours after PCI (P>0.05). (2) There was no significant difference inheart rate and blood pressure between the two groups and there wasn't patient of the two groups who suffered from cardiac tamponade, post infarction angina and needed emergency recanalization after PCI (P>0.05). (3) InE ST(the total ST-segment elevation excluding avR) and ESTI(EST index), no significant differences were observed before or 15 days after PCI (P>0.05), but there was a significant difference 4 hours after PCI(P <0.05) , between the two groups. (4) The peak of serum concentration of CK and CK-MB in control group was significantly higher than that in Liqustrazin group ( P <0.05).Conclusion Intravenous Liqustrazine after PCI can significantly improve myocardialmicrovascular perfusion, attenuate no-reflow phenomenon, leading to better cardiac function in comparision with PCI alone.