Assessment outcomes of delayed and emergent percutaneous coronary intervention in 48 patients with ST-segment elevation myocardial infarction

Objective To observe the clinical effects and safeness of delayed and emergent percutaneous coronary intervention(PCI)for patients with ST-segment elevation myocardial infarction(STEMI).Methods In total of 48 patients with STEMI,20 patients underwent delayed PCI and 28 patients underwent emergent PCI.The parameter of balloon,stent and the time of PCI were observed;After PCI Thrombolysis in Myocardial Infarction(TIMI)flow grade,no-flow phenomenon,ventricular arrhythmia,heart function,the incidence of in-hospital clinical success of PCI and MACE were observed.Results 50 branches of the infarct-related coronary artery(IRA)was intervened in 48 patients who were implanted 55 stents including 46 drug-eluting stents(DES).Clinical success(angiographic success and freedom from major adverse cardiac events)was 89.6% for the entire PCI,82.1% for the emergent PCI group,and 100% for the delayed PCI group.Overall,in-hospital mortality for the entire PCI was 6.2%.Compared with emergent PCI,Delayed PCI increased the length of implanted stents(27.10±4.10% vs 23.00±5.86,P0.01),decreased ventricular arrhythmia(10% vs 42.8%,P0.05),recovered TIMI 3 flow grade(100% vs 85.7%),decreased no-flow phenomenon(0 vs 10.7%),improved heart function(53.4±4.2 vs 54.7±6.3)and decreased the incidence of in-hospital MACE(0 vs 17.8%,P0.05).Conclusion Delayed PCI for IRA in the optimal time is safe and feasible.But in the era of DES further clinical studies are needed to confirm long-term outcomes of delayed PCI for IRA.