Feasibility of simultaneous stent implantation on target lesion and borderline lesion of anterior descending coronary artery in treatment of acute ST segment elevation myocardial infarction

WANG Wenliang; CHEN Shaomin; XIA Meng

doi:10.3969/j.issn.1002-266X.2016.35.005

Abstract：Objective To investigate the feasibility of using simultaneous stent implantation on target lesion and bor-derline lesion of anterior descending coronary artery in treatment of acute ST segment elevation myocardial infarction ( STE-MI) .Methods Seventy-six acute STEMI patients with anterior descending coronary artery as culprit artery were treated by primary percutaneous coronary intervention ( PCI) , and there was a borderline lesion beyond the target lesion in the culprit artery.The patients were randomly divided into two groups: the observation group ( n=37 ) and the control group ( n=39 ) .Patients in the observation group were performed with simultaneous stent implantation on both target and borderline le-sions in the culprit artery, while in the control group, they were performed with stent implantation on target lesion only.We calculated and compared the incidence of complication during PCI operation, the incidence of cardiovascular events in hos-pitalization period and the incidence of major adverse cardiac events ( MACE) within 1 year in both groups.Meanwhile, we detected and compared the levels of B-type natriuretic peptide ( BNP) in plasma in both groups on day 1, 5 and 10 after the different interventions as well as the left ventricular end-diastolic dimension ( LVDd) and left ventricular ejective fraction (LVEF) in both groups in 1, 6 and 12 months after the operation.Results Compared with the control group, the inci-dence of complication during PCI operation and the incidence of cardiovascular events in hospitalization period were signifi-cantly higher in the observation group (all P<0.05);and the levels of BNP on day 1, 5 and 10 after the different inter-ventions were significantly higher in the observation group (all P<0.05).There was no statistically significant difference in LVDd and LVEF in 1, 6 and 12 months after the operation between the observation group and control group;and there was no statistically significant difference in MACE within 1 year between the observation group and control group.Conclu-sions Simultaneous stent implantation on both target and borderline lesion in anterior descending coronary artery of acute STEMI increased the incidence of complication during primary PCI operation and the incidence of cardiovascular events in hospitalization period as compared with that of stent implantation on target lesion only, and it was not conducive to the re-cent recovery of cardiac function in patients, and had no significant effect on long-term cardiac function and MACE of pa-tients.