Combination therapy reduces the percutaneous coronary intervention acute myocardial infarction incidence of no-reflow after primary in patients with ST-segment elevation  

作　　者：Shan-Shan ZHOU Feng TIAN Yun-Dai CHEN Jing WANG Zhi-Jun SUN Jun GUO Qin-Hua JIN 

机构地区：[1]Department of Cardiology, Chinese PLA General Hospital Fuxing Road 28, Haidian District, Beij'ing 100853, China

出　　处：《Journal of Geriatric Cardiology》2015年第2期135-142,共8页老年心脏病学杂志（英文版）

摘　　要：Background No-reflow is associated with an adverse outcome and higher mortality in patients with ST-segment elevation acute myocardial infarction （STEMI） who undergo percutaneous coronary intervention （PCI） and is considered a dynamic process characterized by multiple pathogenetic components. The aim of this study was to investigate the effectiveness of a combination therapy for the prevention of no-reflow in patient with acute myocardial infarction （AMI） undergoing primary PCI. Methods A total of 621 patients with STEMI who underwent emergency primary PCI were enrolled in this study. Patients with high risk of no-reflow （no-flow score 〉 10, by using a no-flow risk prediction model, n = 216） were randomly divided into a controlled group （n = 108） and a combination therapy group （n = 108）. Patients in the controlled group received conventional treatment, while patients in combination therapy group received high-dose （80 mg） atorvastatin pre-treatment, intracoronary administration of adenosine （140 ~tg/min per kilogram） during PCI procedure, platelet membrane glycoprotein lib/Ilia receptor antagonist （tirofiban, 101.tg/kg bolus followed by 0.15 ~tg/kg per minute） and thrombus aspiration. Myocardial contrast echocardiography was performed to assess the myocardial perfusion 72 h after PCI. Major adverse cardiac events （MACE） were followed up for six months. Results Incidence of no-reflow in combination therapy group was 2.8%, which was similar to that in low risk group 2.7% and was significantly lower than that in control group （35.2%, P 〈 0.01）. The myocardial perfusion （A= 13） values were higher in combination therapy group than that in control group 72 h after PCI. After 6 months, there were six （6.3%） MACE events （one death, two non-fatal MIs and three revasculafizations） in combination therapy group and 12 （13.2%） （four deaths, three non-fatal MIs and five revascularizations, P 〈 0.05） in control group. Conclusions Combination of thrombus aspi

关 键 词：Acute myocardial infarction Myocardial contrast echocardiography No-reflow phenomenon Percutaneous coronary interven-tion ST-elevation myocardial infarction 

分 类 号：S858.216.4[农业科学—临床兽医学] R542.22[农业科学—兽医学]