Study Of Neuroendocrine And Cardiac Enzyme Change In Patients With Acute Myocardial Infarction Using Thrombectomy

Objective To study neuroendocrine,Cardiac enzyme,TIMI and corrected TIMI frame count change and clinical value of using percutaneous thrombectomy system (GuardWire PlusTM) for ST Segment elevation Acute Myocardial Infarction(STEMI).Methods 72 patients with STEMI underwent percutaneous coronary intervention (PCI) were divided into two groups. Thrombus Aspiration group (38 patients), with direct stent after thrombectomy, No Thrombus Aspiration group (34 patients), with primary PCI. The plasma ET,PRA,ALD,Angâ…¡,NE and E levels in patients were measured on the day of operation and the first day,second day,third day,fifth day after PCI.The MYO,CK-MB and CTNI levels in patients were measured before operation and the fourth hour,eighth hour,twelfth hour,sixteenth hour,twenty-fourth hour,the second day,third day,fifth day after PCI.The TIMI Flow Grades,Corrected TIMI frame count(CTFC) and ST segment' were measured after PCI.. In order to evaluate the left ventricular systolic function, left ventricular ejection fraction (LVEF) was measured by colour echocardiography at a week and three months after PCI.Results Patients of the two groups were successfully implanted stent. All the neuroendocrine factors have no difference between the two groups before operation. The neuroendocrine factors declined rapidly after PCI according to the curve. ET,PRA,Angâ…¡,ALD,NE and E of Thrombus Aspiration group were significantly lower than No Thrombus Aspiration group(P<0.05)at the first or second day after PCI; but the third and fourth day have no difference. MYO,CK-MB and CTNI have no difference between the two groups before operation and after PCI (P<0.05),but TA group declined rapidly,The peak of TA group is ahead of NTA group. There was a positive correlation between neuroendocrine and Troponin I. The coronary arteriography after PCI demonstrated that the TIMI have no difference between the two groups, the Corrected TIMI frame count between the two groups was significant difference(P< 0.05) ST segment have no difference after PCI for two hours between the two groups (P>0.05).LVEF have no difference after PCI for a week between the two groups (P>0.05),but after three months TA group was significantly high than NTA group (P<0.05)Conclusions Deteriorated neuroendocrine and Troponin I change were significantly improved with thrombectomy, which brought forward the peak of CTNI,relieved damage for myocardium,improved perfusion and implied potential benefits on heart function.