Protective Effect And Prognosis Of Shexiang Baoxin Pill On Myocardium In Patients With Acute St-segment Elevation Myocardial Infarction

Objective To evaluate the protective effect of Shexiang Baoxin Pill on myocardial reperfusion,myocardial infarction area,myocardial ischemia reperfusion injury(MR/RI),cardiac function and major adverse cardiovascular and cerebrovascular events in patients with acute ST-segment elevation myocardial infarction(STEMI).Method 110 STEMI patients who were admitted to Second District of Cardiology Department of Ordos Central Hospital for the first time to undergo direct percutaneous coronary intervention(PPCI)were excluded from 7 patients who did not meet the inclusion criteria.The remaining patients were randomly divided into control group(n=52)and Musk Baoxin Pill group(n=51).All patients were treated with routine drug therapy and PPCI or PTCA.The baseline characteristics(sex,age,smoking history,past hypertension,diabetes mellitus,history of cerebral infarction,family history of coronary heart disease,admission heart rate,systolic blood pressure,diastolic blood pressure,creatinine,blood sugar,low density lipoprotein,hypersensitive troponin and time of myocardial ischemia)between the two groups were analyzed.Myocardial reperfusion(TIMI blood flow,myocardial perfusion after PPCI or PTCA)was analyzed between the two groups.Myocardial infarction area(peak value of hypersensitive troponin(hsTNT),myocardial infarction area,MR/RI(rescue myocardium,rescue index),cardiac function(left ventricular ejection fraction,N-terminal brain natriuretic peptide precursor)and major adverse cardio-cerebrovascular events(cardiogenic death,non-fatal reinfarction,new heart failure,transient cerebral deficiency)There is no difference between hemorrhagic attack and new cerebral infarction.Results There was no difference in baselinecharacteristics between the two groups(P > 0.05).There was no difference in TIMI blood flow grading(P = 0.649)and MBG grading(P = 0.005)in the Shexiang Baoxin Pill group compared with the control group.The ST-segment fall level of ECG in Shexiang Baoxin Pill group was significantly higher than that in control group(73.04±24.25 vs 63.30±22.14,P=0.036),and the peak value of hsTNT was lower than that of the control group(5.54 ±3.23 vs 7.09±4.51,P=0.048).The infarcted myocardial area was smaller than that of the control group [6.50(3.00-15.00)vs 15.00(4.00-29.50),P=0.047].There was no significant difference in risk myocardium [8.00(3.00-25.75)vs 18.00(5.25-29.00),P=0.234] between the two groups.Myocardial salvage [2.50(0.125-9.750)vs 1.00(-1.30-3.50),P=0.023] and salvage index [27.95(0.00-45.00)vs 4.30(-18.35-20.55),P=0.006] were larger than those in the control group.The left ventricular ejection fraction was higher than that of the control group(56.53±7.42%)vs 53.27±9.09%)and the NT-proBNP level was lower than that of the control group(567.02±988.82)vs 1014.86±1259.38).However,the incidence of major cardiovascular and cerebrovascular adverse events did not decrease significantly in the Musk Baoxin Pill group(P=0.511).Conclusion Shexiang Baoxin Pill can improve myocardial reperfusion(MBG classification,ST segment depression of ECG),reduce myocardial infarction area(peak value of hypersensitive troponin,infarcted myocardial area),reduce MI/RI(rescue myocardium,rescue index),improve cardiac function(left ventricular ejection fraction,N-terminal brain natriuretic peptide precursor),and protect myocardium,but it does not improve the main function of STEMI patients.Cardiovascular and cerebrovascular adverse events.