Efficacy And Safety Of Imported And Domestic Iodixanol In Emergency PCI For Patients With Acute ST-segment Elevation Myocardial Infarction

Objective: To compare the efficacy and safety of imported and domestic iodixanol in patients with acute ST-segment elevation myocardial infarction(STEMI)undergoing emergency PCI.Methods:From February 2018 to February 2019,patients with STEMI who underwent emergency coronary angiography(CAG)and received emergency percutaneous coronary intervention were enrolled in the Department of Cardiology,Second Hospital of Hebei Medical University.The selected patients were divided into the following two groups according to the random number table method: group A(using domestic iodixanol)and group B(using imported iodixanol).All the selected patients’ basic data and surgical related parameters were collected,and the renal function indexes of patients before and after surgery were collected,including serum creatinine(SCr)and urea nitrogen(UREA)at the time of admission and 24 h,48h,72 h after PCI.Level,calculate the estimated glomerular filtration rate(eGFR),and record the incidence of contrast-induced nephropathy(CIN)in the two groups;compare the adverse reactions of contrast in the two groups Conditions,angiographic quality,and major adverse renal and cardiovascular events(MARCE)were followed up for 1 month.All data were statistically processed using SPSS 22.0 software,and the difference was statistically significant at P< 0.05.Results:This study included a total of 98 STEMI patients who underwent CAG from the Second Hospital of Hebei Medical University from February 2018 to February 2019 and received emergency PCI.Among them,50 patients in group A and 48 patients in group B.There was no significant difference in the general baseline data between the two groups.There was no significant difference in the distribution of vascular blood vessels,TIMI blood flow,and contrast agent dosage(P>0.05).One patient in group A and group B had mild adverse reactions of contrast agents,all of which were transient.There was no significant difference in adverse reactions between the two groups(P>0.05).There were 46 cases of excellent vascular image quality in group A,4 cases in good condition,and the overall effective rate was 100%;46 cases of excellent vascular image quality in group B,2 cases in good condition,the overall effective rate was 100%;There was no significant difference in angiographic effects(P>0.05).The renal function index of patients in group B was better than that in group A.At 24 hours after PCI,the level of Scr in group A was significantly higher than that in group B(88.48±18.61μmol/L vs 79.88±17.41μmol/L,P=0.010).The level of eGFR in group A was significantly lower than that in group B(79.40±15.73 ml.min-1.1.73m-2 vs 91.01±20.85 ml.min-1.1.73m-2,P<0.05);48 hours after PCI,group A UURE The level was significantly higher than that of group B(7.38±2.28 μmol/L vs 6.41±1.61 μmol/L,P=0.012).The incidence of CIN in group B was lower than in group A(6.3% vs 20.0%,P=0.045).There were 5 cases(10%)and 3 cases(6.3%)of recurrence angina in group A and group B,and 2 cases(4%)and 1 case(2.1%)of AKI,respectively.There was no significant difference in the incidence of MARCE between the two groups(P>0.05).Conclusion:In the emergency PCI operation of STEMI patients,both domestic and imported iodixanol could provide good vascular imaging with few adverse reactions.However,the lower side effects of import of iodixanol on renal function and the incidence of CIN were found.