Clinical Analysis Of Emergency PCI In539Patients With STEMI

Objective：To explore the relevent factors of recent clinical prognosis for emergency PCI inthe treatment of acute ST-segment elevation myocardial infarction, and to provide evidencefor better clinical efficacy.Materials and methods: A retrospective analysis of539cases with acute ST-segmentelevation myocardial infarction who were treated with emergency PCI in Ningxia MedicalUniversity General Hospital from January in2002to March in2012.Results:1. The average length of stay, the intraoperative ventricular fibrillation incidence,immediate blood flow TIMI3grade, ejection fraction, local bleeding or hematomacomplications as well as the mortality rate of transradial emergency PCI are significantlybetter than the transfemoral artery emergency PCI. That is of great statistical significance (P <0.05).2. Among the three groups, the diastolic diameter of left ventricle measured viaechocardiography within one week, the over50%ST-fall, local bleeding or hematomacomplications, incidence of acute heart failure, and mortality rate, the differencese havestatistical significance (P <0.05). In the early and middle group, they are not statisticallysignificant (P>0.05), but both significantly better than the late group (P <0.05).3. The immediate blood flow TIMI3grade, the over50%EF, the over50%ST-fall aswell as the death rate of Tirofiban group are significantly better than the control group. That isof great statistical significance (P <0.05);the local complications of bleeding or hematomabetween two groups have no statistical significance（P＞0.05）.4. The immediate blood flow TIMI3grade, the over50%EF as well as the over50%ST-fall of aspiration catheter group were higher than those in the control group, and the differencese have statistical significance (P <0.05).5. Among the three groups, the immediate blood flow TIMI3grade, ejection fraction, leftventricular end-diastolic diameter and mortality rate, the differencese have statisticalsignificance (P <0.05). In the Tirofiban joint aspiration catheter group and alone tirofiban orsuction catheter group, they are not statistically significant (P>0.05), but both significantlybetter than the control group (P <0.05).6. Cardiogenic shock group of patients in the average length of stay, the intraoperativeventricular fibrillation incidence, the immediate blood flow TIMI3grade, the over50%ST-fall, local bleeding or hematoma complications as well as the mortality rate are worse thanthe control group, and the differencese have statistical significance (P <0.05).7. Death group of patients in age, diabetes, smoking history, different surgical approach,different reperfusion time and with cardiogenic shock have statistical significance comparedwith the survival group, they are independent factor for increased mortality of patients.Conclusion:1. When patients with acute ST-segment elevation myocardial infarction undergoemergency PCI, radial puncture is more safe and effective.2. The earlier reperfusion time, the better prognosis.3. When patients with acute ST-segment elevation myocardial infarction undergoemergency PCI, Tirofiban can improve the myocardial reperfusion, reduce the death rate, anddoes not increase the risk of bleeding.4. When patients with acute ST-segment elevation myocardial infarction undergoemergency PCI, aspiration catheter can improve the myocardial reperfusion, and improve theprognosis.5. Tirofiban and aspiration catheter jointly applied to Emergency PCI make it moreeffective and significant improvement in patients with myocardial reperfusion and prognosis.6. Emergency PCI can reduce the mortality rate of patients with acute ST-segment elevation myocardial infarction together with cardiogenic shock and improve prognosis.7. Age, diabetes, smoking, different surgical approach, different reperfusion time,cardiogenic shock are independent factor for increased mortality of patients.