摘要
Abstract
Objective To investigate the influence of coronary stent implantation timing on the therapeutic effect in patients with acute ST-segment elevation myocardial infarction(STEMI).Methods A retrospective analysis was conducted on the clinical data of 191 STEMI patients.They were divided into two groups based on the timing of coronary stent implantation treatment.Ninety-two patients underwent immediate coronary stent implantation(immediate implantation group)within 12 h after symptom onset,while 99 patients received 7-10 days of dual antiplatelet therapy before coronary stent implantation(delayed implantation group).We compared the cardiac function,levels of myocardial injury markers,severity of thrombus burden,coronary blood flow status,incidence of no reflow,and incidence of major adverse cardiovascular events(MACEs)between the two groups before and after surgery.Results One month after surgery,the LVEF in the delayed implantation group was significantly higher than that in the immediate implantation group[(49.63±5.42)%vs.(44.79±4.83)%,P<0.01].The left ventricular end-diastolic diameter was(40.57±4.57)mm,the left ventricular end-systolic diameter was(41.15±3.67)mm,the creatine kinase isoenzyme level was(20.37±1.69)U/L,cTn I was(0.12±0.02)ng/mL,and the myoglobin was(75.69±4.31)ng/mL,all significantly lower than those in the immediate implantation group[(44.32±5.36)mm,(45.01±4.24)mm,(25.46±2.44)U/L,(0.21±0.04)ng/mL,and(83.21±5.09)ng/mL,respectively,all P<0.01].The delayed implantation group demonstrated superior thrombolysis in myocardial infarction(TIMI)blood flow grades compared to the immediate implantation group,while its incidence of no reflow was significantly lower than that of the immediate implantation group(3.03%vs.10.87%,P<0.05).There was no statistically significant difference in the incidence of MACEs between the two groups(3.26%vs.2.02%,P>0.05).Conclusion Compared with immediate coronary stent implantation,delayed coronary stent implantation demonstrates advantages in improving cardiac function of STEMI patients,reducing myocardial injury and thrombus burden,and recovering coronary blood flow perfusion.关键词
急性ST段抬高型心肌梗死/冠状动脉支架植入术/心功能/心肌损伤标志物/不良心血管事件Key words
acute ST-segment elevation myocardial infarction/coronary stent implantation/cardiac function/myocardial injury marker/adverse cardiovascular event分类
医药卫生
