Comparison between Primary and Delayed PCI in Patients with Acute Myocardial Infarction

Objective: To evaluate the efficacy between primary percutaneous coronary intervention (PCI) and delayed PCI in patients with acute myocardial infarction (AMI). Methods: Two hundred patients with AMI were treated with either primary PCI (80 cases) or delayed PCI(120 cases). The general clinical characteristics and cardiac events were analysed. Left ventricular ejection fraction (LVEF), end diastolic volume index (EDVI) and end systolic volume index (ESVI) of the left ventricle were measured by two-dimensional echocardiography 7-10 days after PCI. Results: Unstable angina (12.50% vs 24.17%,P 0.05) and non-fatal heart failure (10.00% vs 21.67%, P 0.05) decreased significantly in primary PCI group compared to those in delayed PCI group. The incidence of arrhythmia during the operation in primary PCI group was higher than that of delayed PCI group (67.50% vs 26.67%, P 0.05). However the cardiac death didn't increase. EDVI, ESVI and LVEF in primary PCI group were much better compared to those in delayed PCI group. Conclusion: The incidence of ventricular fibrillation, sinus arrest and severe sinus bradycardia seems to increase during the operation in primary PCI patients compared to those in the delayed PCI group. Meanwhile, primary PCI can efficiently re-open the infracted coronary artery, reperfuse the myocardial infarction focus and improve the left ventricular diastolic function.