Ventricular Remodeling Of Intervention Research The Delayed Percutaneous Coronary In Patients With Acute Myocardial Infarction

Objective: Discussion among patients with acute myocardial infarction undergoing delayed PCI after treatment of left ventricular remodeling and cardiac function。Through the admission, when January, when in June of serum B-tape natriuretic peptide and ultrasonic cardiography evaluation of left ventricular remodeling value。Through clinical observation and follow-up period of delayed PCI group compared with the simple medication group improve the clinical symptoms and the near and long-term efficacy (including patient mortality, major cardiovascular events and the incidence of complications, etc.) of the gifted poor, further evaluation of patients with acute myocardial infarction undergoing delayed PCI the safety, effectiveness。Methods: The research adopt the approach of reviewing , prospective formation and contrast, and election from March 2008 to October 2008 a complete patient information in line with the WHO diagnostic criteria for acute myocardial infarction in patients with initial 80 cases, all for the incidence of AMI within 12h-30d patients, one of 38 cases of male, female 42 cases。According to different treatment methods are divided into delayed PCIgroup (42 cases) and the simple medication group(38 cases).The two groups on admission, one month, six months fasting serum B-tape natriuretic peptide (BNP) values, parallel ultrasonic cardiography (UCG) to check and record the heart long axis, short axis and four chamber heart cavity and the two chamber heart cavity images, obtained at the end of left ventricular systolic volume (LVESV), end-diastolic volume (LVEDV) and left ventricular ejection fraction (LVEF) and other values.Results: (1)Baseline information (on admission):two groups of patients in age, sex combined hypertension, diabetes, hypercholesterolemia, smoking history, infarct location, lesion length, degree of stenosis, the proportion of single-vessel disease, myocardium zymology, follow-up time, Contrast the results of pre-treatment, serum B-tape natriuretic peptide values, left ventricular ejection fraction (LVEF) and cardiacfunction, such as a balanced comparability between the two groups was without statistics difference (P> 0.05);(2)delayed PCI group::the treatment of 42 cases of stent implantation were 74, IRI average narrow intensity (92±6.43)%before the operation,postoperative angiography showed residual stenosis <20%, the TIMI3 grade blood flow of full recovery;(3)Clinical observation during hospitalization:hospitalization during the period of delayed PCI group and the simple medication group compared to the average length of hospital stay, mortality, the incidence of cardiovascular events than there is significant difference (P <0.05);(4)one-months follow-up: two groups of left ventricular size and BNP results show, delayed PCI group and the simple medication group compare to left ventricular ejection fraction (LVEF),left ventricular end-diastolic volume (LVEDV), left ventricular end systolic volume (LVESV) , the left ventricular sizeshrinks, ejection fraction increased (P <0.05), BNP values decreased (P <0.05);(5)six-month follow-up: two groups of left ventricular size and BNP results show, delayed PCI group and the simple medication group were simply left ventricularejection fraction (LVEF), left ventricular end-diastolic volume (LVEDV),left ventricular end volume (LVESV) compared with significantly reduced left ventricular size, ejection fraction increased significantly (P <0.05), BNP values decreased significantly (P <0.05),and compared with one month left ventricular ejection fraction (LVEF), left ventricular end-diastolic volume (LVEDV), left ventricular end systolic volume (LVESV) also significantly reduced left ventricular size,left ventricular ejection fraction (LVEF ) also significantly increased (P <0.05), BNP values also decreased significantly (P <0.05);(6)one -month,six-month follow-up:delayed PCI group than the simple medication group, the primary endpoint events as well as the United endpoint events the incidence of low endand there is significant difference (P <0.05);Conclusions: Delayed PCI treatment of acute myocardium infarction is a kind of safe and effective therapeutic measures。Delayed PCI treatment of acute myocardium infarction is significance in prevent theleft ventricular remodeling and improve the heart function。Delayed PCI groupwith the simple medication group,the number of days hospitalized, near and long-term composite rate of cardiac events is significantly lower。During hospitalization and follow-up of the joint end (cardiac death, non-fatal re-infarction, target vessel revascularization) rate and the secondary endpoint (heart failure, and ischemic attack) the occurrence of rate are lower。Therefore the acute myocardium infarction patients are carried out delayed PCI treatment after losing emergency PCI treatment time because of various reasons, if condition permit during certain time。Compared to simple medication treatment, delayed PCI treatment of acute myocardium is still better treatment choice. It can save cardiac muscle of infarction around it, reduce infarction to extend, prevent theleft ventricular remodeling and reduce the electrical instability of cardiac muscle, to improve the heart function, reduce the incidence of the main heart incident.。There is important clinical meaning。...