Effects of Percutaneous Coronary Intervention Time on Left Ventricular Remodeling in Patients with Acute Myocardial Infarction
|School||Dalian Medical University|
|Keywords||Acute myocardial infarction Left ventricular remodeling Treatment of percutaneous coronary intervention ( PCI )|
Objective: To investigate the different time undergoing PCI of left ventricular remodeling after acute myocardial infarction and cardiac function . Method : random sample of my hospital stay in our department from January 2008 to March 2009 65 patients with a first acute myocardial infarction admitted to hospital and treated with PCI patients ( 48 men and 17 women , mean age 62.72 years ) , of which the first wall myocardial infarction in 43 cases ( 66.2% ) , posterior and right ventricular myocardial infarction in 22 cases, accounting for 33.8% . Groups: early group ( lt ; 12 hours , n = 21 ) , the late group ( 12-72 hours , n = 15 ) , elective group ( more than 72 hours , n = 29 ) in accordance with the onset of symptoms to the time of PCI . Admission all patients were treated with anticoagulant , anti-platelet , anti-ischemic basic drug therapy during hospitalization (mean length of hospitalization was 7 days) and 6 months after myocardial infarction expert echocardiographic determination of left ventricular end-diastolic diameter ( LVEDD ) , left ventricular ejection fraction ( LVEF ) , to determine ventricular remodeling and left ventricular function , comparative analysis of the results . Results: 1, during hospitalization earlier group of cardiac function ( LVEF ) was significantly better than the other two groups ( 56.38 ± 4.03 % VS50.87 ± 7.78 % , 56.38 ± 4.03 % VS52.59 ± 7.42 % , P lt ; 0.05 ) : follow-up six months among the three groups no significant difference in heart function . 2 , either during hospitalization or follow - up of 6 months , no significant difference among the three groups left ventricular end diastolic diameter ( LVEDD ) . 3, the early group followed up for six months than during hospitalization LVEDD With significantly reduced (48.14 ± 3.53mmVS46.36 ± 4.20mm, P lt; 0.05). 4, sub-group analysis : the early group of 43 patients with anterior wall infarction patients during hospitalization cardiac function is still higher than the late group and elective group, and the earlier group of left ventricular end-diastolic diameter was still significantly reduced . Elective group during hospitalization and follow - up of 6 months LVEDD values ??were greater than the late group ( during hospitalization 47.26 ± 5.19mmVS46.24 ± 3.56mm : follow-up six months 47.58 ± 6.32mmVS47.71 ± 5.65mm ) . 8 cases of aneurysm formation in 7 cases ( 87.5% ) occurred in the anterior myocardial infarction , 1 case of the lower wall myocardial infarction . Conclusion: Early PCI can significantly improve STEMI patients during hospitalization cardiac function , and significant improvement in left ventricular remodeling . For anterior myocardial infarction , the late PCI compared with elective PCI significant improvement in left ventricular remodeling . Thus miss the timing of early PCI patients with acute anterior myocardial infarction can be considered as early as possible late PCI .