Clinical Efficacy Of Thrombus Aspiration In Different Time After Onset Of ST-Segment Elevation Myocardial Infarction

Objectives:With the rapid development of China’s economy,the incidence of coronary heart disease(CHD)in China has increased year by year and is on a younger trend.Controlling risk factors and improving the treatment of myocardial infarction can effectively prevent the occurrence of coronary heart disease and reduce its threat to people’s health.Emergency percutaneous coronary intervention(PCI)is the most important treatment for patients with myocardial infarction at present.no-reflow phenomenon is an important reason that affects the curative effect of patients after PCI.The purpose of this study is to evaluate the curative effect of thrombus aspiration,analyze and compare the curative effect of thrombus aspiration in PCI at different time segments(from symptom onset to different time of thrombus aspiration in catheter room),and provide basis for further optimizing treatment in clinic.Methods:A total of 127 patients with acute ST-segment elevation myocardial infarction(STEMI)who were admitted to the Department of Cardiology of the First Affiliated Hospital of Nanchang University from January 2015 to June 2018 and diagnosed as high-load thrombosis by percutaneous coronary angiography were choosen for our study.According to whether manual manual thrombus aspiration was used.,the patients were divided into group A for thrombectomy PCI(63 cases)and group B for routine PCI(64 cases).According to the time from onset to guidewire passing through criminal vessels,According to ≤6h,> 6h and ≤12h,> 12 h and ≤24h,group A was divided into A1 group(23 cases),A2 group(27 cases)and A3 group(13 cases).group B was divided into B1 group(25 cases),B2 group(25 cases)and B3 group(14 cases).TIMI blood flow classification,1hST segment fall after PCI,left ventricular ejection fraction(LVEF)7 days after PCI,and major unconscionable vascular events(MACE)3 months after PCI were compared among the groups.Results:1、In group A,the proportion of TIMI blood flow reaching grade 3 after PCI,the proportion of complete ST segment decline in electrocardiogram 1 hour after PCI and the left ventricular ejection fraction of echocardiography reexamination 7 days after surgery were all higher than that in group B,and the difference between groups was statistically significant(P < 0.05).There was no significant difference in MACE incidence between group A and group B 3 months after PCI(P > 0.05).2.In group A2,the proportion of TIMI blood flow reaching grade 3 was higher than that of group B2,and the difference was statistically significant(P < 0.05);in group A3,the proportion of postoperative TIMI blood flow reaching grade 3,the proportion of postoperative ST segment complete fallback,and the left ventricular ejection fraction of echocardiography 7 days after PCI were all higher than that of group B3,and the difference was statistically significant(P < 0.05).There was no significant difference in MACE incidence between group A1 and B1,groupA2 andB2,groupA3 and B3within3 months after surgery(P>0.05).Conclusion:Thrombus aspiration is beneficial to reduce the incidence of no-reflow or slow blood flow,improve postoperative myocardial perfusion,improve left ventricular function inpatients with high thrombus-loaded STEMI,and may reduce adverse effect ofthe prolongation of myocardial ischemia time,especially within 12-24 hours of myocardial ischemia.