Application Of Intravascular Ultrasound In The Emergency Percutaneous Coronary Intervention Of The ST-Elevation Myocardial Infarction Complicated With Type 2 Diabetes Mellitus

Objective The value of intravascular ultrasound(IVUS)for coronary interventional diagnosis and treatment of type 2 diabetes mellitus(T2DM)complicated with coronary heart disease has been widely recognized.However,for STEMI patients complicated with T2 DM,the significance of IVUS for these patients under the premise of rapid and safe emergency PCI has been rarely reported.This study aims to explore the application value of IVUS in STEMI patients with T2 DM and expand the use of IVUS.Methods A retrospective analysis was conducted on 58 cases of STEMI complicated with type 2 diabetes within 12 h of onset time,and they were divided into28 cases in the study group and 30 cases in the control group according to whether IVUS examination was performed.Ivus-guided interventional therapy was applied in the study group,and angiography guided interventional therapy was performed in the control group.Maximum diameter,total length,number of stents,rate of implantation,rate of noncompliance,incidence of major adverse events(MACE),left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD),and rate of stent resenosis 1 year after surgery.Results There was no significant difference in the rate of stent placement,the rate of stent not up to standard,the left ventricular final diastolic diameter(LVEDD)and left ventricular ejection fraction(LVEF),and the incidence of cardiac major adverse events(MACE)between the two groups(P > 0.05).The number of stents placed in the study group was more than that in the control group.The total length of stent placement in the study group was longer,the maximum diameter of stent placement in the study group was larger,the time from the passage of the guide wire through the lesion to the completion of PCI was longer,and the postoperative stent restenosis rate was lower,Difference between the two groups has fairly significance.(P < 0.05).Conclusion The use of IVUS in the emergency interventional treatment of STEMI patients with T2 DM is safe,and does not increase the incidence of complications due to prolonged operation time.IVUS examination can obtain more intracoronary imaging features,including calcified nodules,unstable plaques,and intracranial hematoma/dissection,etc.,to assist the surgeon in selecting the optimal treatment strategy.This includes placing stents with larger internal diameter and longer stent size,covering vulnerable coronary plaques as widely as possible,obtaining larger stent lumen cross-sectional area,and reducing the rate of intrastent restenosis 9 months after surgery.