摘要
Abstract
Objective To study the optimal timing of stent implantation in patients with acute ST segment elevation myocardial infarction (STEMI).Methods 351 acute STEMI patients undergoing emergency PCI stent implantation in the Department of Cardiology,Beijing Anzhen Hospital,Capital Medical University and the Heart Center,Affiliated Hospital,Beihua University from January 2015 to June 2016 were selected in the study.According to the timing of stent implantation,the patients were divided into immediate stent implantation group (n =310) and delayed stent implantation group (n =41).Drug eluting stent (DES) was implanted into patients in the immediate stent implantation group immediately after percutaneous transluminal coronary angioplasty (PTCA);PCI treatment was stopped after patients in the delayed stent implantation group received PTCA,they received continuous antithrombotic therapy for 7 to 12 days,and then DES was implanted.The pathological lesions of coronary artery,treatment condition,stents implantation situation,the postoperative effect and perioperative incidence of major adverse cardiovascular events (MACE) of patients in the two groups were compared.Results The distribution of infarct -related artery (IRA) and thrombus burden score of patients in the two groups were significantly different (P ＜ 0.05);there was no significant difference in the time from the symptom onset to balloon dilatation and the rate of performing thrombus aspiration (P ＞ 0.05).There were significant differences in stent number and stent length of patients between the two groups (P ＜ 0.05);there was no significant difference in stent diameter of patients between the two groups (P ＞ 0.05).There were significant differences in rate of TIMI Ⅲ grade,rate of MBG Ⅲ grade and occurrence rate of distal embolization of patients between the two groups (P ＜ 0.05).There was significant difference in the incidence of MACE during the perioperative period of patients between the two groups (P ＜ 0.05).Conclusion For hemodynamically unstable patients with STEMI of high thrombus burden,delayed stent implantation after opening IRA can significantly reduce distal embolization events,improve myocardial perfusion,protect the overall function of the heart,reduce the incidence of MACE,and increase the benefit of patients.关键词
心肌梗死/血管成形术,气囊,冠状动脉/支架植入Key words
Myocardial infarction/Angioplasty, balloon, coronary/Stent implantation分类
医药卫生
