Efficacy of precision intracoronary thrombolysis via microcatheter in elderly patients with acute myocardial infarction
10.3969/j.issn.1009-0126.2024.09.005
- VernacularTitle:微导管冠状动脉内精准溶栓治疗老年急性心肌梗死的作用
- Author:
Sanyi WANG
1
;
Shuangshuang PENG
;
Cai LI
Author Information
1. 330006 南昌大学第二附属医院心内科
- Keywords:
myocardial infarction;
coronary vessels;
thrombolytic therapy;
microcatheter
- From:
Chinese Journal of Geriatric Heart Brain and Vessel Diseases
2024;26(9):1002-1006
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the efficacy of precision intracoronary thrombolysis via micro-catheter in the treatment of acute myocardial infarction(AMI)in the elderly based on inhibiting ventricular remodeling and myocardial protection.Methods A total of 106 elderly AMI patients admitted to our hospital from January 2022 to January 2023 were enrolled,and randomly divided into thrombolysis group(50 patients)and primary PCI group(56 patients).Echocardiography was used to measure the left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD),left atrial diameter(LAD),and left ventricular ejection fraction(LVEF)be-fore and 1 month after operation.Levels of creatine kinase isoenzymes-MB(CK-MB),high-sensitivity cardiac troponin T(hs-cTnT),and high sensitivity C-reactive protein(hs-CRP)were assessed.Major adverse cardiac events(MACE)within 30 d after operation were observed,and ad-verse drug reactions were observed.Results The primary PCI group had significantly lower LVEDD,LVESD and LAD values(40.08±5.18 mm vs 47.22±5.08 mm,29.12±5.07 mm vs 35.33±5.13 mm,33.07±5.07 mm vs 40.08±5.18 mm,P＜0.01),while obviously higher LVEF value[(55.08±5.17)％vs(49.07±5.19)％,P＜0.01]than the thrombolysis group.LVEDD,LVESD and LAD values were notably decreased and that of LVEF was remarkably increased in both groups after operation(P＜0.05).Statistical differences were observed in CK-MB,hs-cTnT and hs-CRP levels between the two groups before and 8 and 24 h after procedure(P＜0.01),with the levels at 8 and 24 h postoperatively significantly higher than those before operation,and the levels at 24 h obviously higher than those at 8 h after operation(P＜0.05).Additionally,the inci-dence of MACE was significantly higher in the primary PCI group than the thrombolysis group(16.1％vs 4.0％,P＜0.05).Conclusion Microcatheter intracoronary thrombolysis can signifi-cantly improve ventricular remodeling in elderly AMI patients and exert a myocardial protective role.
