Evaluation on curative effect and safety of interventional treatment for patients with acute myocardial infarction

Abstract

To evaluate the effectiveness and recent safety of emergency and selective percutaneous coronary intervention (PCI) in elderly patients (≥80 years old) with acute myocardial infarction (AMI). 120 elderly patients with coronary heart disease (CHD) were divided into AMI group (with 55 cases) and non-myocardial infarction group (control group with 65 cases). Among the AMI group, there were 18 cases underwent emergency PCI within 12 hours after the onset, (AMI emergency PCI group), the rest 37 cases were AMI selective PCI group. In the control group, 2 cases had stable angina pectoris, 59 cases unstable angina pectoris and 4 patients old myocardial infarction. The lesions were classified according to the practice guidelines of American College Of Cardiology/American Heart Association (ACC/AHA). The hospitalized major adverse cardiac events (MACE) and complications in the patients were recorded and statistically analyzed. The AMI group had a higher total Gensini score, lower left ventricular ejection fraction (LVEF), less mean stents and contrast agent dosage and shorter operation time, compared with the control group. The difference was statistically significant. Though the average postoperative length of stay in AMI emergency PCI group was longer than that of AMI selective PCI group, but the difference had no statistical significance. To all the included patients, there were 50 cases with lesions in one branch, 43 cases in two branches and 27 cases in three branches. And the immediate PCI success ratio in AMI group was lower than that in control group (80% VS. 96.9%, P= 0.003), without significant difference in the distribution number of diseased vessels and complete reconstruction ratio (P>0.05). The incidence of the total complications in AMI emergency PCI group was higher, compared with the non-emergency group (with 102 cases) and AMI selective PCI group (P<0.001, P=0.039); and the occurrence rate of complication in AMI group was higher than that of the control group (P<0.001). The emergency PCI for elder patients with AMI is safe and worthy of promotion.