Effects of reperfusion-time on left ventricular remodeling and prognosis in patients with anterior acute myocardial infarction treated with percutaneous coronary intervention

Objective To evaluate the impact of reperfusion-time on left ventricular remodeling and long-term mortality in patients with anterior acute myocardial infarction (AMI) undergoing successful primary percutaneous coronary intervention(PCI). Methods A total of 113 patients with primary anterior AMI were enrolled,in whom coronary angiography revealed a total occlusion of infarct-related artery (IRA) (TIMI 0-1). According to the reperfusion-time for PCI,the subjects were divided into three groups: group A (35 patients),the reperfusion-time 6 h; group B (40 patients),the reperfusion-time between 6 and 12 h; group C (38 patients),the reperfusion-time between 12 and 24 h. All patients underwent the coronary artery angiography and left ventricular angiography both immediately and at 6 months. The left ventricular end diastolic volume,left ventricular end systolic volume,left ventricular ejection fraction,cardiac output,and cardiac index were compared among the three groups. Main adverse cardiac events (MACE) during one year follow-up,including angina,heart failure,myocardial infarction,and cardiac death were also compared among the groups. Results There was no difference in parameters of heart function among the three groups immediately after successful reperfusion. At 6 months,the heart function in group A and B was improved,but not in group C. During one year follow up,there was no death or recurrence of myocardial infarction in group A and B. There was no difference in angina incidence among the three groups. There was higher incidence of heart failure and death in group C than in group A and B. Conclusion Early PCI in patients with anterior AMI is recommended. It can achieve IRA revascularization,prohibit left ventricular remodeling,improve heart function,and decrease incidence of MACE,thus long-term prognosis can be improved.