Application Of Intra-aortic Balloon Pump In Acute ST Segment Elevation Myocardial Infarction

Objective: To evaluate the effect and prognosis of intra-aortic balloon pump implantation therapy in different implantation time of acute ST segment elevation myocardial infarction; and the effect of it in acute ST segment elevation myocardial infarction with severe heart failure. Methods:For 164 cases from January 2012 to December 2014 who were diagnosed with acute ST segment elevation myocardial infarction were divided four groups according to the time of implantation IABP after AMI :67 cases in group A is equal to or less than 6 hours implantation time; 41 cases in group B is more than 6 hours and is equal to or less than 12 hours implantation time; 34 cases in group C is more than 12 hours and is equal to or less than 24 hours implantation time; 22 cases in group D is more than 24 hours implantation time,other 49 cases in heart failure subgroup: according to whether with the severe heart failure. All of them were collected with gender, age, hypertension, diabetes, smoking, blood lipid, uric acid, serum creatinine and other relevant information. Four groups were compared with the use time of IABP and hospitalization days, the changes of blood pressure and heart rate before and after the treatment of IABP, the changes of LVEF before and 1year after its, the incident rate of major cardiovascular within 1 year. Acute ST segment elevation myocardial infarction with severe heart failure were compared the changes of LVEF、NT-proBNP、systolic blood pressure, diastolic pressure, heart rate before and after treated with IABP.Data were analyzed with two sample t test, one-way ANOVA, paired t test, diversity rate card square test. Results:1.There were no significant difference in age, gender, hypertension history, blood lipid, uric acid, serum creatinine, smoking history and other basic information(P>0.05), the medical data of these four groups are comparable. 2.There were no significant difference in vascular lesions, the number of crimes,stent implantation(P>0.05). 3.No matter before and after the implantation therapy of IABP, four groups blood pressure had no significant difference( P>0.05), before the treatment of IABP four groups heart rate had significant difference(P<0.05), no significant difference after the treatment of IABP(P>0.05),but every group of systolic blood pressure(SBP)and diastolic blood pressure(DBP) were higher than before treatment and HR were lower than before treatment,it was significantly difference(P<0.05)(P<0.05). 4. In 12-24 hours implantation time the level of after 1year LVEF were higher than before treatment, it was significantly difference(P<0.05). 5.There is significant in the use time of IABP(P<0.05), the results between two groups are listed below: patient with A group and B group have no statistically significant difference, compared two groups in other groups have statistically significant difference. but there is no significant in hospitalization days(P>0.05).6.The incident rate of major adverse cardiovascular events within 1year is no significantly difference(P>0.05).6. Systolic blood pressure(SBP)and diastolic blood pressure(DBP) were higher than before treatment and HR were lower than before treatment, it was significantly difference(P<0.05).7.The level of LVEF were higher than before treatment, it was significantly difference(P<0.05).8.The level of NT-proBNP were drop significantly before treatment, it was significantly difference(P<0.05). Conclusion: 1.With the longer different implantation time of acute ST segment elevation myocardial infarction have the faster heart rate and the worse heart function 2.12-24 hours implantation time of acute ST segment elevation myocardial infarction can increase LVEF obviously after treated with IABP.3 Acute ST segment elevation myocardial infarction can be improved the hemodynamic after treated with IABP, especially 12-24 hours implantation time of them.4.The hospitalization days of acute ST segment elevation myocardial infarction does not increase after treated with IABP.5. After 1 year the incident rate of major adverse cardiovascular events have no effect in different disease time of acute ST segment elevation myocardial infarction after treated with IABP.6.IABP can improve the hemodynamic, decrease NT-pro BNP and increase left ventricular ejection fraction(LVEF) in acute ST IABP indication is worth clinical application.