Objective:To explore the influence of different transport modes on the efficacy of direct percutaneous coronary intervention (PCI) in patients with acute ST‐elevation myocardial infarction (STEMI) .Methods :A total of 268 STEMI patients undergoing emergency PCI during Jan 2013 and Dec 2014 were selected .Among them ,there were 139 patients whose single‐time 12‐lead ECG results were scanned and sent to specified cardiologists ’ cellphones by ambulances or community doctors via wechat app (chest pain center mode exploration group ) and 129 patients who went to hospital by themselves (common treatment group) .The door to balloon dilatation time (D‐to‐B) ,the probability of D‐to‐B shorter than 90 minutes (target rate ) , the mortality during hospitalization , the incidence of heart failure , the average hospitalization days and hospitalization cost were compared between the two groups .Results:The results of comparison between the chest pain center mode exploration group and the common treatment group were shown as below :the D‐to‐B time ([86 .4 ± 4 .5] min vs .[97 .4 ± 10 .3] min ,P<0 .01) ,hospital during mortality (2 .9% vs9 .3% ,P<0 .05) ,the incidence of heart failure (4 .3% vs .11 .6% ,P<0 .05) ,the average hospitalization days ([8 .7 ± 3 .2] d vs .[10 .9 ± 4 .5] d ,P<0 .05] and hospitalization costs ([50 347 ± 19 310] yuan vs .[58 102 ± 41 178] yuan ,P<0 .05) .And all the differences were statistically significant .Conclusions :Regional chest pain center mode can shorten the reperfusion time and reduce the short‐term mortality for STEMI patients .

Objective To analyse reperfusion arrhythmias in AMI patients treated by direct PCI. To investigate prevention and treatments so as to elevate operation achievement ratio.Methods One hundred and seventy six AMI patients underwent direct PCI; of the 176 patients, 56 presented reperfusion arrhythmias. Observations were made in the context of the different arrhythmias, relation between the time onset of the arrhythmias after reperfusion, relation of infarct size number of the involved vessels and the infarct size to the arrhythmias. Results PCI performed with six hours after AMI showed much higher incidence of arrhythmias than PCI performed six to twenty four hours after AMI (P0.05).Conclusions Reperfusion arrhythmias were commonly seen in AMI patients treated by direct PCI. Early prevention and detection with appropriate treatment is the key to elevate survival rate leading to a better prognosis.

Objective To investigate the incidence and clinical significance of “no flow” (NF) phenomena after primary percutaneous coronary intervention (PCI) in the treatment of acute myocardial infarction (AMI). Methods ninety nine consecutive AMI patients underwent primary PCI were devided into NF group (18 cases) and non NF group (81 cases). The incidence of NF, clinical characteristics, blush grade, ST T segment elevation, peak CPK, left ventricular function and cardiac events were analysed. Results Eighteen patients demonstated NF, the incidence of NF was 18.2%. Compared with non NF, previous MI、diabetes、anterior MI and multivessel disease were more frequently observed in the cases with NF ( P 0.05). Conclusions The incidence NF after primary PCI in the treatment of AMI is 18.2%. The patients with NF show malperfusion in the myocardial microcirculation, larger infarct size, ventricular dysfunction and poor prognosis.

Objective To compare primary PCI with venous thrombolysis on the clinical effect in patients with AMI. Methods One hundred and thirty two consecutive patients with acute myocardial infarction during thirteen months were divided into primary PCI group( n =75) and venous thrombolysis group(n=57).The reperfusion rate and cardiac events during in hospital and follow up were recorded in two groups. Results The reperfusion rate of venous thrombolysis was 57.9% and 96% in primary PCI group( P

0.05, all statistically insignificant. Conclusions: Primary PCI was equally effective for the treatment of one vessel and multivessel AMI patients.

Objective To investigate the effect of delayed PTCA and stenting for infarct related artery on the chronic phase of left ventricular remodelling and cardiac events in patients with acute myocardial infarction. Methods Fifty two patients with primary acute myocardial infarction were divided into PTCA group ( n =27) and non PTCA group ( n =25). Twenty seven patients underwent PTCA and coronary stenting with an average of 12 days after the acute onset. Left ventricular end diastolic volume (LVEDV), left ventricular end systolic volume (LVESV), left ventricular ejection fraction (LVEF) and cardiac events in each group were followed up. Results There were no significant differences in preoperation and postoperation for LVEDV and LVESV in the PTCA group, on the contrary a significant increase for before and after follow up for LVEDV and LVESV in the non PTCA group( P 0.05). Conclusions Delayed PTCA and stenting for infarct related artery would inhibit ventricular enlargement and delay chronic phase of left ventricular remolding. Moreover, cardiac events were significantly reduced in patients with acute myocardial infarction after delayed PTCA and stenting.