Interventional therapy versus direct interventional therapy for acute ST-segment elevation myocardial infarction after intravenous thrombolysis:a comparative study
MENG Xianghui
AN Qunying
SUN Guoning
Abstract：Objective To compare the efficacy,safety,and cost-effectiveness of interventional therapy versus direct interventional therapy for acute ST-segment elevation myocardial infarction(STEMI)after intravenous thrombolysis.Methods A total of 58 STEMI patients who met the clinical diagnostic standard and admitted to the Sixth People's Hospital of Hengshui between May 2023 and November 2023 were retrospectively recruited.They were divided into the experimental group(direct interventional therapy,n=30)and control group(interventional therapy prior to intravenous thrombolysis,n=28).General information,recanalization rate(proportion of postoperative thrombolysis in myocardial infarction[TIMI]3 flow in the culprit vessel),left ventricular ejection fraction(LVEF),and incidence of adverse events were compared between groups.Results There were no significant differences in the baseline characteristics between groups(P＞0.05).No significant difference was detected in preoperative recanalization rate between the experimental group and control group(10％[3/30]vs 7.1％[2/28],P＞0.05).A significant difference was detected in postoperative recanalization rate between the experimental group and control group(83.3％[25/30]vs 50％[14/28],P=0.007).Preoperative LVEF was comparable between groups(P＞0.05),while postoperative LVEF at 4 weeks significantly increased in both groups,especially in the experimental group(P＜0.05).No significant difference was detected in the incidence of adverse events between groups(P＞0.05).Conclusion Interventional therapy with thrombolysis as the priority offers a better efficacy on STEMI than the direct interventional therapy by implanting stents.The proportion of postoperative TIMI 3 flow in the culprit vessel is higher in STEMI patients managed by interventional therapy after intravenous thrombolysis.An optimal therapy should be determined by individualized conditions and actual medical sources.More comparative studies are needed to further compare the safety,effectiveness and economic cost.
Keywords：acute myocardial infarctionrecanalization rateinterventional therapyintravenous thrombolysisadverse events
Publication Date：2024-11-25
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 3412-3415 )