Reperfusiontherapy strategy of acute ST-segment elevation myocardial infarction inprimary hospital

CHEN Xin-dong; ZHU Zhi-jun; HUANG Yan-zhen; CHEN Yong-hui; YANG Yu-sheng; LIN Han-xun; XU Jian-feng; FANG Jing-cai

doi:10.3969/j.issn.1674-4055.2016.08.08

Abstract：ObjectiveTo study the reperfusion therapy strategy of acute ST-segment elevation myocardial infarction (STEMI) in primary hospital.Methods200 STEMI patientsfrom August 2011 to July2013 in Lufeng county people's hospital were randomlydivided intothrombolysis group (n=100), and thrombolytic+PCI group (n=100). Thrombolysis group received routine treatment combined with thrombolytic therapy;thrombolytic+PCI group received routine treatment combined with thrombolytic therapyplus PCI. Left ventricular end systolic diameter (LVESD), left ventricular end-diastolic diameter (LVEDD) and left ventricular ejection fraction (LVEF) before treatmentand 7 daysafter treatmentwere compared. The cost of treatment, incidence of re-infarction, re-hospitalization and mortality during hospitalization and after treatment for six months, 1 year and 2 years were compared.ResultsLVESD and LVEDD were significantly higher in thrombolysis group than thrombolysis+PCI group, and LVEF was lower in thrombolysis group 7 days after treatment, the difference was statistically significant (P<0.05). Incidence of re-infarction in thrombolysis group was significantlyhigher than thrombolysis+PCI group1 and 2 years after treatment (P<0.05). Incidence ofre hospitalizationinthrombolysis +PCI groupwas significantly lower than thrombolysis group six months, 1 and 2 years after treatment(P<0.05). The total cost of thrombolysis group was significantlylower than thrombolysis +PCI group (P<0.05).ConclusionSTEMI thrombolytic therapy can effectively improve the myocardial blood supply and treatment cost is relatively low. This therapy is more suitable for primary hospitalswhere patients are difficult transferred quickly. Appropriate selection of thrombolytic therapy should be pay attention to, for example, PCI should be given to patients who need it.