The Clinical Study Of ST-segment Resolution Of Patients With STEMI After Direct PCI

Objective:To observe the ST-segment resolution,creatine kinase cTnT and LVEF of patients with STEMI after direct PCI and TIMI flow reaching 3 grade in order to investigate the relationship between ST-segment resolution and myocardial damage as well as cardial systolic function.Methods:115 patients with their first acute STEMI underwent successful direct PCI with onset 12 hours were considered for enrolment in the study.After PCI,all the patients' IRA had achieved TIMI 3 grade.A 12-lead ECG was recorded before and after PCI to assess the ST-segment resolution.The CK,CK-MB and cTnT were measured before and after PCI.LVEF was measured after PCI.Patients were divided into two groups according toΣSTR:group A:ΣSTR＜50%(21 cases) as myocardial reperfusion bad group and group B:ΣSTR≥50%(94 cases) as myocardial reperfusion well group.Results:1.There were no significant differences between the two groups with regard to age,sex,mean blood pressure,heart rate,incidence of hypertension and diabetes mellitus,body-mass index,incidence of pre-hospital heart failure,level of cholesterol and triglyceride.2.There was no difference between the two groups with respect to many angiographic variables:location of culprit lesion,TIMI flow grade before perfusion,elapsed time from the onset of symptoms to reperfusion.3.There were no significant differences between the two groups with regard to the CK,CK-MB before and after PCI..4.There was no difference between the two groups with cTnT before PCI.The cTnT level of the group B was higher than that of the group A after PCI (1.30±0.43vs1.0±0.45,P＜0.05).5.The LVEF in the group B were significantly higher than that of the group A(44.13±4.83vs47.93±5.23,P＜0.05).Conclusions:After acute STEMI direct PCI,the patients with the TIMI flow 3 grade and the satisfactory ST-segment resolution maybe have better myocardial reperfusion and the lighter extent of myocardial damage as well as better cardial systolic function.