Effect of facilitated percutaneous coronary intervention on ventricular remodeling in patients with acute myocardial infarction

Objective:To evaluate the effect of primary percutaneous coronary intervention(PCI),transradial facilitated PCI and thrombolysis therapy on ventricular remodeling in the eldly with acute myocardial infarction(AMI) by equilibrium radionuclide angiography(ERNA).Method:One hundred and forty-three primary anterior ST segment elevation AMI patients of onset10 hours were randomly divided into primary PCI group(n=71) and facilitated PCI group(n=72),while 70 patients with matching clinical features for thrombolytic treatment group at the same period.At 1 and 28 weeks after AMI onset,the parameters of left ventricular systolic function and paradox volume index(PVI) were measured by ERNA,and major adverse cardiac events(MACE) were recorded.Result:①The patency of IRA before PCI in thrombolytic treatment group and facilitated PCI group were markedly higher than that in primary PCI group(31.43% vs 8.45%,χ2=11.69;30.56% vs 8.45%,χ2=11.09;P0.01,respectively).The TIMI-3 grade rate of IRA post-PCI in facilitated PCI group was higher than that in primary PCI group(98.61% vs 88.73%,χ2=4.35;P0.05).②At 28 weeks post-AMI,the parameters of LVEF and PER in the facilitated PCI group were increased(t=2.08,2.13,P0.05,respectively),while TPER,PVI were decreased(t=2.10,2.49,P0.05,respectively) compared with those in primary PCI group.③There were no significant differences between the facilitated group and the primary PCI group in complication rates.The incidence of MACE of 28 weeks follow-up in facilitated PCI group and primary PCI group were significantly lower than that in thrombolytic treatment group(8.33% vs 54.29%,χ2=35.05;8.45% vs 54.29%,χ2=34.49,P0.01,respectively).Conclusion:The transradial facilitated PCI therapy may significantly inhibit left ventricular remodeling and improve the left ventricular function by the complete,persistent repatency of IRA,which was superiority to the primary PCI and thrombolytic therapy.