Clinical Significance Of Pre-hospital Thrombolysis Followed PCI In The Treatment Of Patients With Acute ST-segment Elevation Myocardial Infarction

Objective To investigate the clinical efficacy and safety pre-hospital thrombolysis transport to facilitated PCI in patients with acute STEMI(ST elevation myocardial infarction).Methods A total of 170 STEMI patients who were treated in our clinic within 12 h since onset of their symptoms from Oct 2015 to Oct 2017 were collected.All eligible patients were divided into transport group(pre-hospital thrombolysis and transport to facilitated PCI,n=80)and primary PCI group(p PCI group,n=90).Patients should be removed if they were cardiogenic shock,accepted thrombolysis in the hospital,or resuscitated before.Immediate TIMI(Thrombolysis In Myocardial Infarction)flow grade of infarct-related artery(IRA)before and after PCI treatment,post-operative CTFC(Corrected TIMI Frame Count)and TMPG(TIMI myocardial perfusion grade)were compared between these two groups.The incidence of bleeding during hospital stay,left ventricular function at 6 month after intervention and major adverse cardiac events(MACE)were all observed.Rusults There is no obvious difference between the baseline of two groups.Before PCI,the proportion of TIMI grade 2-3 was higher in combination group(78% vs18%)than that in p PCI group;but there was no significant difference in the proportion of TIMI grade 2-3 between these two groups after PCI.The rate of TMPG3 is higher(78% vs 71%,)in transport group than those in p PCI group.No significant difference was found in the incidence of bleeding and MACE during hospital stay and Left ventricular function at 6 months after operation between these two groups.By contrast,LVEFs were higher after 3 and 6 months of the intervention compared to those before intervention in both groups..Conclusions It is a safe and effective reperfusion strategy for STEMI patients to receive pre-hospital thrombolytic therapy and transport to PCI as an alternative way to those who failed to receive p PCI on time.It did not increase the occurrence of bleeding complications and MACE,and at the same time it presented the same benefit in improving recent cardiac function as p PCI did.