Long-term effect of direct percutaneous coronary intervention on left ventricular remodeling in patients aged 75 years and over with acute myocardial infarction

Objective To investigate the long-term effect of direct percutaneous coronary intervention (PCI) on left ventricular remodeling in patients aged ≥75 years with acute myocardial infarction (AMI). Methods 108 cases of patients with acute myocardial infarction were collected into the study. Direct PCI were completed in patients in PCI group within 12 hours of onset. Patients in non-PCI group received conventional conservative treatment with drugs. Patients were followed up for 0.5-8.0 years, and cardiac function (NYHA) and the detected ultrasonic cardiogram were evaluated during follow-up. Results The 106 patients received follow-up. Two female patients who were not treated with PCI died during follow-up, one patient died of sudden cardiac death and another patient died of severe pneumonia. Compared with non-PCI group, direct PCI group showed that cardiac function (NYHA) grade was lower(t=3.17, P<0.05), the end-systolic and end-diastolic volume of left ventricle were less(t=3.50、3.90, all P<0.01), the left ventricular ejection fraction was increased (t=2.00, P<0.05), the ventricular wall motion index was smaller (t=2.96, P<0.01). E/A ratio was higher, E wave deceleration time was shorter, and left ventricular mass index was smaller (t=4.04, 4.29, 4.70, respectively, all P<0.01), the left ventricular long and short axis diameter were decreased (t=2.30, t=5.53, P<0.05 or 0.01), and Spherical index was increased (t=2.97, P<0.01). Conclusions Direct PCI treatment improves chronic ventricular remodeling in elderly patients with AMI and contributes to long-term improvement in cardiac function. Key words: Myocardial infarction; Ventricular remodeling; Angioplasty, transluminal, percutaneous coronary therapy