| Objective: To study the short-time effcets of different time to electivepercutaneous coronary intervention(PCI)on left ventricular remodeling andprognosis for patients with ST segment elevation myocardial infarction(STEMI),and to analyze the short-time effects of different infarct position,infarct related artery and the value of creatine kinase on left ventricularremodeling for patients with STEMI, and to investigate if patients withSTEMI who have lost the best time of treatment can benefit from elective PCI.Methods: We selected61cases of patients living in our hospital whoaccepted elective percutaneous coronary intervention after acute myocardialinfarction. All patients were thrombolysis in myocardial infarction(TIMI)grade0~1. All patients were divided into2groups according to the time fromonset of AMI to elective PCI: shorter than7days and longer or equal to7daysbut shoter than30days, according to the infarct position all the patients weredevided into anterior group and non-anterior group, according to the largestvalue of creatine kinase in the first3days after the onset of STEMI all patientswere devided into less than1000U/L group,1000U/L~2000U/L group andmore than2000U/L group. Echocardiography was performed before electivePCI and was reviewed1and3months after elective PCI respectively to detectleft ventricular end diastolic volume(LVEDV),left ventricular end systolicvolume(LVESV),left ventricular ejection fraction(LVEF), LVEDV andLVESV were rectified to left ventricular end diastolic volume index(LVEDVI)and left ventricular end systolic volume index (LVESVI)bybody surface area. According to comparing all indicators of echocardiographyand major adverse cardiac events during3months follow-up between and within groups, we evaluated the short effects of different time to elective PCIon left ventricular remodeling and prognosis. According to comparing allindicators of echocardiography between and within anterior group andnon-anterior group, we evaluated the short-time effects of different infarctposition on left ventricular remodeling for patients with AMI, and according tocomparing all indicators of echocardiography among and within differentvalue of creatine kinase groups we evaluated the short-time effects of differentvalue of creatine kinase on left ventricular remodeling for patients with AMI.Results: The basic conditions in two groups before elective PCI werenot different statistically.(P＞0.05). LVEDVI,LVESVI and LVEF were notdifferent statistically in two groups before elective PCI,1months afterelective PCI and3months after elective PCI.(P＞0.05), LVEDVI andLVESVI in both groups were not different significantly within group betweenthe stage of before elective PCI and1month after elective PCI(P＞0.05).LVEDVI and LVESVI in both two groups3months after elective PCI weresignificantly smaller than that before elective PCI and1month after electivePCI(P＜0.05), LVEF in two groups were not different significantly withingroup among the stages of before elective PCI,1month after elective PCIand3month after elective PCI(P＞0.05). The major adverse cardiac events(including angina, heart failure, re-myocardial infarction, death)were notdifferent significantly in two groups during3months following-up. LVEDVI,LVESVI and LVEF were not different statistically between anterior group andnon-anterior group before elective PCI and1months after elective PCI(P＞0.05), LVESVI and LVEF were not different statistically between anteriorgroup and non-anterior group3months after elective PCI(P＞0.05), LVEDVIin anterior group was significantly larger than non-anterior group3monthsafter elective PCI(P＜0.05)；LVEDVI and LVESVI in anterior group andnon-anterior group were not different significantly within group between thestage of before elective PCI and1month after elective PCI(P＞0.05),LVEDVI and LVESVI in both anterior group and non-anterior group3monthsafter elective PCI were significantly smaller than that before elective PCI and 1month after elective PCI(P＜0.05), LVEF in anterior group and non-anteriorgroup were not different significantly within group among the stages of beforeelective PCI,1month after elective PCI and3month after elective PCI(P＞0.05). LVEDVI,LVESVI and LVEF were not different statistically amongthree value of creatine kinase groups before elective PCI,1months afterelective PCI and3months after elective PCI(P＞0.05); LVEDVI and LVESVIin three value of creatine kinase groups were not different significantly withingroup between the stage of before elective PCI and1month after electivePCI(P＞0.05), LVEDVI and LVESVI in three value of creatine kinase groups3months after elective PCI were significantly smaller than that before electivePCI and1month after elective PCI(P＜0.05), LVEF in three value of creatinekinase groups were not different significantly within group among the stagesof before elective PCI,1month after elective PCI and3month after electivePCI(P＞0.05).Conclusion: The shoert-term effect on left ventricular remodeling ofelective PCI between which is done shorter than7days and longer or equal to7days but shorter than30days was not different significantly, the degree ofleft ventricular remodeling in anterior myocardial infarction was more seriousthan non-anterior myocardial infarction3month after elective PCI in patientswith STEMI, but the different effects on left ventricular remodeling afterelective PCI between different largest value of creatine kinase within3daysafter the onset of STEMI were not different significantly. |
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