| Objective: To investigate the optimal time of percutaneous coronary intervention (PCI) for patients with acute myocardial infarction(AMI) and the feasibility of primary PCI for patients with AMI and a pre-hospital delay of > 12-24 hours by compared the ventricular performance and prognosis of different time PCI for patients with AMI.Methods: 95 patients with initial AMI in our hospital from January 2001 through September 2001 were enrolled .They were 75 men and 19 women; age range : 34-87 years (mean 58.8+11.8). There were no difference significantly in baseline clinic characteristics in all groups, including age ,sex,previous history ,high risk factors,place and size of infartion,the time to follow-up,number of culprit vessel and the branches of IRCA .According to the time to reperfusion, they were divided into three PCI groups and a no reperfusion group: the first group: <6h 31 cases, the second group: 6-12h 25 cases, the third group: 12-24h 20 cases, the fourth group: no reperfusion (contrast group) 19 cases. The patients of three PCI groups were receivedstandard PCI and routine therapy of AMI .The patients of fourth group were only received routine therapy of AMI. The rate of success to PCI ,the duration of PCI ,the frequency of achieve TIMI-III flow in the infarct related coronary artery (IRCA) and the complications in PCI groups were recorded . The main cardiovascular events (MACE) in all groups were also recorded in hospital and 6 months after AMI. Ultra echocardiogrphy (UCG) ,99mTc-MIBI rest myocardial perfusion imaging (RMPI) and equilibrium radionulide angiocardiography (ERNA) were performed at 7 and 180 days after AMI . The myocardial infarct size was gained by the quantitative analysis with bull's-eye display . The parameters of left ventricular performance were obtained by UCG, ERNA ,including LVEF, PER, TPER, PFR, TPFR and PS . LVEDV and LVESV were evaluated to ventricular remodeling .Results: l.The degree of stenosis(96.8?12)% of IRCA and the rate of total occlusion artery in the first group were higher than other groups (P<0.05) . The rate of success to PCI ,the duration of PCI ,the frequency of achieving TIMI-III flow in the IRCA and dessection accompanied by PCI in each of PCI categories were similar regardless of time to reperfusion. The mortality in hospital and 6 months in the fourth group was higher than other PCI groups, the rate of reinfarction was also higher than other three groups(P<0.05). No difference was found in the incidence of strock in allgroups . 2.The MIS in the early reperfusion (<6h) was the smallest in all groups (P<0.05). 3.At 7 days , the LVEF of all groups were 65.85+ H.51%,58+12.89%,58.85+10.52%,50.17+ 10.05% respectively . The LVEF in the early group(<6h) was better than that of other groups (P<0.05) . The LVEF of the second group and the third group were higher than that of the fourth group , but there was no difference between this two groups (P>0.05) . The results of PER and TPER was same to LVEF . The PFR and TPFR in the fourth group were worse than other three groups (P<0.05), but no difference was found in three PCI groups. 4.The LVEDV and LVESV of all groups were 135.4 + 24.13ml, 136.5 +26.55 ml, 134.3 +25.21 ml, 158.67 + 27.85 ml ; 60.4 + 12.69 ml,60.25 + 11.62 ml,58.57 + 11.39 ml,73.33+14.18 ml respectively . The LVEDV and LVESV in the fourth group were worse than that of other PCI groups (P<0.05) ,no difference was found in other three PCI groups. 5. The results of PS was similar to those of LVEDV and LVESV. 6.The results of left ventricular performance and the ventricular remodeling at 180 days were similar to those of 7 days . But the MIS in the fourth group was significantly increased , the difference was significantly compared with other PCI groups (P<0.05) . 7.At 180 days LVEF,PER and PFR in three PCI groups were improved significantly compared with that of 7 days (P<0.05), while the TPER and TPFR were significantly decreased (P<0.05) . The LVEDVand LVESV were also reduced slightly , no difference was found between 7 days and 180...
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