Clinical Study Of IABP In Patients With Acute Anterior Wall Myocardial Infarction With Multiple Vessel Lesions

Objective:To evaluate the clinical efficacy of early treatment with intra-aortic ballon pump(IABP)in patients with acute anterior myocardial infarction and multi-vessel disease treated with emergency percutaneous coronary intervention(PCI).Methods:Patients with acute anterior myocardial infarction who were admitted to Affiliated Nanhua Hospital,University of South China from January 2018 to August 2019 and underwent emergency coronary angiography showed that the Left Anterior Descending branch was a criminal vessel and at least one of the Right Coronary Artery and Left Circumflex artery had a stenosis degree ?50%,disease to criminals patency time for 3 to 12 hours,line before PCI are not cardiogenic shock(CS).There were 53 patients who met the inclusion criteria.According to whether the patients were graded with IABP in Killip after admission,26 patients of KillipII grade or KillipIII grade were implanted with IABP before PCI(IABP group),KillipI grade 27 patients did not receive IABP implantation before PCI(control group).The patient's gender,age,hypertension,diabetes,blood lipid and other relevant clinical data were collected.By t test,non-parametric testand card square test,etc.,the preoperative and postoperative cTnI,NT-proBNP,left ventricular ejection fraction(LVEF)values of patients in thewere compared,and the postoperative survival rate at 30 days and the incidence of major adverse cardiovascular events(MACE)at 6 months in the two groups were compared.Results:1.There were no significant differences in general clinical data(gender,age,hypertension,diabetes,etc.),coronary artery condition and PCI surgical options between the two groups(P>0.05).2.Comparison of preoperative and postoperative cTnI values: The preoperative cTnI value of IABP group was significantly higher than that of control group,and the difference was statistically significant(P < 0.05).The cTnI value of the two groups decreased 7 days after surgery,and the cTnI value of the IABP group was significantly lower than that of the control group,with a statistically significant difference(P < 0.05),and the cTnI value of the IABP group was significantly higher than that of the control group 7 days after surgery,with a statistically significant difference(P < 0.05).The postoperative cTnI value of IABP group decreased significantly compared with that of the preoperative group,and the difference was statistically significant(P < 0.05).3.Comparison of preoperative and postoperative NT-proBNP values:preoperative NT-proBNP value of the IABP group was significantly higher than that of the control group,and the difference was statistically significant(P < 0.05).The value of NT-proBNP in the IABP group was significantly lower than that in the control group at 7 days after surgery,and the difference was statistically significant(p < 0.05).In addition,the value of NT-proBNP in the control group was increased compared with that before surgery,the value of NT-proBNP in the IABP group was decreased compared with that before surgery,and the value of NT-proBNP in the IABP group was significantly higher than that in the control group,and the difference was statistically significant(P <0.05).The postoperative value of NT-proBNP in IABP group decreased significantly compared with that before surgery,and the difference was statistically significant(P < 0.05).4.Comparison of preoperative and postoperative LVEF values: there was no significant difference in LVEF values between the two groups before and 7 days after surgery(P>0.05).5.Comparison of survival rate at 1 month after surgery between the two groups: there was no significant difference between the IABP group and the control group(P> 0.05).6.Comparison of the incidence of major adverse cardiac events 6months after surgery between the two groups: there was no significantdifference between the IABP group and the control group(P> 0.05).Conclusion:For patients with acute anterior myocardial infarction accompanied by multi-vessel disease,the use of IABP adjuvant therapy may have the significance of improving the clinical efficacy on the basis of PCI and related drug therapy.