The Effect Of Late Percutaneous Coronary Intervention On Left Ventricular Function In Patients With Acute Myocardial Infarction

Objective:To observe whether late percutaneous coronary intervention(PCI)can improve long-term left ventricular function in patients with acute myocardial infarction.Methods:A retrospective analysis was performed on 230 hospitalized patients diagnosed with acute myocardial infarction from May 2013 to December 2017,including 187 patients who underwent late PCI(PCI group)and 43 patients who were treated with drugs alone(control group).Patients in the PCI group were divided into STEMI subgroup(106 cases)and NSTEMI subgroup(81 cases)according to the type of myocardial infarction.According to the number of opened coronary arteries in late PCI,patients in the PCI group were divided into 1 coronary artery group(142 cases),2 coronary arteries group(39 cases)and 3 coronary arteries group(6 cases).According to the location of opened infarct-related artery,patients in 1 coronary artery group were divided into left anterior descending branch group(68 cases),left circumflex branch group(28 cases)and right coronary artery group(46 cases).Time standard of late PCI: 14 ~ 30 days after acute myocardial infarction.Echocardiographic data of PCI group before and after late PCI and echocardiographic data of early and late time of infarction in the control group were collected to investigate the effect of late PCI on long-term left ventricular function in patients with acute myocardial infarction.Echocardiographic data of each group were compared to explore whether there is a difference in the improvement of left ventricular function between the STEMI subgroup and the NSTEMI subgroup,and whether different quantity and different coronary arteries undergo advanced PCI have different effects on left ventricular function.Results:1.Echocardiographic data in PCI group and control group were compared,and left ventricular function was significantly improved in late PCI group(P<0.05).The left ventricular ejection fraction(LVEF)and left ventricular shortening rate(LVFS)in PCI group improved,left ventricular end-diastolic diameter(LVEDD)and left ventricular end-systolic diameter(LVESD)in PCI group decreased.While LVEF and LVFS decreased,LVEDD and LVESD increased in control group.2.LVEF and LVFS increased,and LVEDD and LVESD decreased in both STEMI subgroup and NSTEMI subgroup.Echocardiographic changes of STEMI subgroup,NSTEMI subgroup and control group were statistically significant(P<0.05).However,there was no significant difference in the above indicators between the STEMI subgroup and the NSTEMI subgroup(P> 0.05).3.Compared with the control group,LVESD reduced in each different quantity of coronary arteries subgroups,and LVEF increased in 3 infarct-related arteries subgroup,LVEDD decreased in 2 infarct-related arteries subgroup.And these differences are statistically significant.(P<0.05).4.Compared with the control group,LVEDD and LVESD decreased in the left anterior descending branch group,left circumflex branch group and right coronary artery group(P<0.05),and the reduction of left ventricular inner diameter was the most obvious in the open left anterior descending branch group.Conclusion:1.Six months after late PCI,patients with acute myocardial infarction showed significant improvement in left ventricular function.2 There was no difference in cardiac function improvement between STEMI subgroup and NSTEMI subgroup after late PCI.3.In patients with acute myocardial infarction,myocardial remodeling can be inhibited by opening different quantity of infarct-related coronary arteries in late PCI.And the ability of left ventricular ejection can be significantly improved in 3 coronary arteries group.4.Late PCI in different Infarct-related arteries can inhibit left ventricular remodeling.