| Objective We discuss the efficacy and safety of emergent PCI in patients with acute ST-segment elevation myocardial infarction,to provide the basis for clinical intervention therapy.Method We select 240 cases with acute ST-segment elevation myocardial infarction undergoing percutaneous coronary intervention from Sixth Affiliated Hospital of Guangxi Medical University,during the days from June 30,2011 to December 31,2012. According to patients undergoing emergent or elective percutaneous coronary intervention,we put them into emergent PCI treatment group (group A) and elective PCI treatment group (group B),and follow-up 24 months.We compare of the efficacy and safety between the two groups,including differences in the incidence of major adverse cardiovascular events,as myocardial infarction angina pectoris,arrhythmias,heart failure after myocardial infarction,cardiac death,bleeding events,and analysis the result with statistics.Result 1 Between group A and group B in age,gender ratio, residence,education level,occupation,BMI,hypertension,hyperlipidemia, diabetes mellitus,family history of coronary heart disease,history of smoking,history of myocardial infarction,history of atrial fibrillation and history of TIA,the difference was not statistically significant (P> 0.05).2 Between group A and group B time of onset,classification of heart failure,position of myocardial infarction,ejection fraction of left ventricular,end-diastolic diameter of left ventricular,type of vascular lesion,variables of vascular disease and number of vessels opened/ variables of variables,the difference was not statistically significant (P> 0.05).3 Between group A and group B incidence of recurrent cardiac ischemia,heart failure,cardiogenic shock,cardiac suspended,atrial fibrillation and atrioventricular block occurred,the difference was not statistically significant (P> 0.05); The total incidence of major adverse cardiovascular events of group A lower than group B during hospitalization,and the difference was statistically significant(P <0.05).4Three months later discharge,the LVEF in group A was higher than in group B,and the end of the left ventricular diameter of group A was less than group B,and the difference was statistically significant (P <0.05).5 5.1 Followed up for 6 months,12 months,18 months,24 months,incidence of the severe bleeding events was not statistically significant difference (P> 0.05),between group A and group B.5.2 The attendance rate of group A due to cardiovascular events was lower than group B,but the difference was not statistically significant (P> 0.05),by followed up six months,twelve months and eighteen months;The attendance rate of group A due to cardiovascular events was lower than group B,the difference was statistically significant (P<0.05),by followed up twenty four months;The hospitalization rate of group A for cardiovascular events was lower than group B,but the difference was not statistically significant (P> 0.05),by followed up six moriths,twelve months and eighteen months;The hospitalization rate of group A for cardiovascular events was lower than group B,and the difference was statistically significant (P<0.05),by followed up twenty four months.5.3The cardiac death rate of group A was lower than group B,but the difference was not statistically significant (P> 0.05),by followed up six months and eighteen months;The cardiac death rate of group A was higher than group B,but the difference was not statistically significant (P > 0.05),by followed up twelve months;The cardiac death rate of group A was lower than group B,and the difference was statistically significant(P < 0.05),by followed up twenty four months.Conclusion In the treatment of acute ST-segment elevation myocardial infarction,efficacy of emergency PCI is more significant than elective PCI,with less postoperative major cardiovascular events,lower cardiac death,and better long-term prognosis.Emergent PCI is effective and safe,so emergent PCI is worth of extensive clinical application. |
PDF Full Text Request