Clinical Study Of Different Therapeutic Strategies For AMI Patients With Multivessel Disease

objective:This study aims to analyze the data of patients of acute myocardial infarction(AMI) with multivessel disease(MVD) who emergent PCI procedure for infarct-related artery(IRA) and also to investigate whether PCI procedure for severe stenotic non-IRA or drug therapies alone can improve the outcome.Methods: A total of 190 patients treated with primary angioplasty for AMI with MVD were divided in 2 groups:1.(129 patients)patients undergoing percutaneous coronary intervention(PCI) of the infarct-related artery(IRA)only;2. ( 61 patients ) patients undergoing PCI of the IRA followed by staged, in-hospital PCI of the non-IRA(s).Follow up the prognosis. Results: The average age is higher in the incomplete revascularization group; Comparing with multivessel PCI, PCI restricted to the IRA only was associated with higher mortality. In the high-risk subgroups, the MACEs rate and mortality is obviously higher in the incomplete revascularization group. But in the low-risk subgroup, no obvious differences of prognosis were found out between the two groups. Conclusion: For the high-risk patients with AMI multi-vessel disease, a strategy of primary PCI directed at the IRA with staged intervention of the non-IRA is associated with good outcome. In the low-risk patients without objective evidence of residual ischemia, PCI directed at the IRA only could get the similar outcome as the complete revascularization. objective:This study aims to investigate the relation between the biological markers and prognosis of the acute myocardial infarction(AMI) patients with multivessel disease(MVD) who emergent PCI procedure for infarct-related artery(IRA).Methods: A total of 40 patients treated with primary angioplasty for AMI with MVD were divided in 2 groups:group one(ICR group ) including 28 patients undergoing percutaneous coronary intervention(PCI) of the infarct-related artery(IRA) only;group two(CR group) including 12 patients undergoing PCI of the IRA followed by staged, in-hospital PCI of the non-IRA(s).CRP was measured at the 8 hours,48 hours and one week after emergent PCI procedure .BNP,TNF-α, IL-6,sCD40L were measured after emergent PCI procedure .Follow up the prognosis.Results:There are no difference in baseline characteristics and prognosis between the two groups patients ,the patients in the ICR group have higher plasma concentrations of biological markers than the patients in the CR group ,but these difference didn't achieve statistical significance.Plasma concentrations of CRP increased after emergent PCI,and the highest CRP plasma concentrations appeared at 48 hours after emergent PCI which is a strong independent risk factor for future cardiovascular events. There was a significantly positive relation between the plasma concentrations of CRP,BNP,sCD40L and the rate of MACEs . Conclusion: for the AMI patients with multi-vessel disease, plasma concentrations of CRP,BNP,sCD40L which were measured after emergent PCI can predict the future cardiovascular events.