Application Of Intracoronary Retrograde Thrombolysis During Primary PCI In Patients With ST-segment Elevation Myocardial Infarction

Objective:To study the safety and efficacy of precise intracoronary retrograde thrombolysis during primary PCI in patients with ST-segment elevation myocardial infarction.Methods:In this prospective study,a total of 123 consecutive acute STEMI patients received primary PCI in cardiology intervention treatment center of PLA general hospital from 2014-01 to 2015-12 were enrolled.The patients were randomly divided into 2 groups:intracoronary retrograde thrombolysis group(RT,n=60),and thrombus aspiration group(TA,n=63),three patients in TA group were excluded due to failing to complete the thrombus aspiration.The primary end points was the composite outcome of major adverse cardiovascular events(MACE)and the secondry end points was left ventricular ejection fraction(LVEF)by Echocardiographic measurement.Results:The composite end point of MACE rate in RT group was significantly lower than that in TA group(5.0%vs 16.7%,P=0.040).LVEF was significantly higher in RT group than that in TA group((53.6±6.4)%vs(50.2±7.2)%,P=0.014).The rate of cardiac death and serious heart failure in RT group were lower than those in TA group,but the difference were not significant(P>0.05).Conclusion:Compared with thrombus aspiration,intracoronary retrograde thrombolysis in primary PCI could reduce 1-year incidence of MACE and improve Left ventricular systolic function.