The effects of percutaneous coronary intervention (PCI) in combination with thrombus aspiration and platelet glycoproteinⅡb/Ⅲa receptor antagonists during operation on the prognosis of patients with acute ST-elevation myocardial infarction
CHANG Xiao-dong
LIU Bao-xin
XU Yuan-xi
LUO Jia-chen
DAI Li-ming
HOU Lei
LI Wei-ming
WEI Yi-dong
Abstract：Objective To evaluate the effects of percutaneous coronary intervention (PCI) in combination with thrombus aspiration and platelet glycoprotein Ⅱb/Ⅲa receptor antagonists during operation on platelet activities and the prognosis of patients with acute ST-elevation myocardial infarction (STEMI).Methods A total of 358 STEMI patients in the department of cardiology from March 2012 to May 2014 were enrolled in this study. The patients were randomly divided into the thrombus aspiration group (n=179) and control group (n=179). According to whether using platelet glycoprotein Ⅱb/Ⅲa receptor antagonist during operation, each group was divided into two subgroups (Ⅱb/Ⅲa group and non-Ⅱb/Ⅲa group) for further comparison. Platelet count and platelet average volume (MPV), myocardium peak, and ST segment elevation restoration percentage (sum-STR) were recorded pre- operationand at 24 h, 48 h, 72 h after operation. Major adverse cardiovascular events (MACE) were documented during one-year follow-up after discharge.Results Among all subgroups, there were no significant difference with respect to preoperative TIMI flow grade, myocardial infarction related artery, vascular lesions constitute ratio (P>0.05), as well as platelet counts and MPV (P>0.05). However, the platelet count and MPV after operation 24 h, 48 h, 72 h of the subgroup who used platelet glycoprotein Ⅱb/Ⅲa receptor antagonist agent was significantly lower than the other subgroups (P<0.05). TIMI grade 3 ratio and sum-STR 70% ratio in Ⅱb/Ⅲa subgroup were significantly higher than that of the non-Ⅱb/Ⅲa subgroup in both thrombus aspiration and control groups (P<0.05), and the biochemical indicators in Ⅱb/Ⅲa subgroup were significantly lower than that of non-Ⅱb/Ⅲa subgroup in both thrombus aspiration and control groups (P<0.05). The incidence of MACE during one-year follow-up of Ⅱb/Ⅲa subgroup was also significantly lower when compared with non-Ⅱb/Ⅲa subgroup in both thrombus aspiration and control groups (P<0.05).Conclusion PCI combined with thrombus aspiration and platelet glycoprotein Ⅱb/Ⅲa receptor antagonist can reduce blood platelet activation, thereby improve the clinical outcomes in the patients with STEMI.
Keywords：ST-segment elevation myocardial infarctionThrombus aspirationPlatelet glycoprotein Ⅱb/Ⅲa receptor antagonistPlatelet activation
Publication Date：2016-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 1077-1081 )