Emergency PCI combined with thrombolysis and conventional PCI for relieving myocardial injury in patients with ST-segment elevation myocardial infarction:a clinical study
Xing Yanlin
Liu Liyun
Wang Lu
Peng Peichi
Liao Qinwen
Gan Feng
Abstract：Objective To investigate the efficacy and safety of emergency percutaneous coronary intervention(PCI)combined with tenecteplase(TNK-tPA)for relieving myocardial ischemia-reperfusion injury(MIRI)in patients with ST-segment elevation myocardial infarction(STEMI).Methods The patients with initial STEMI(n=100)received emergency PCI were selected and divided,according to different therapies,into combined thrombolysis group and control group(each n=50)in Beijing Aerospace General Hospital from May 2021 to May 2023.The occurrence of arrhythmia due to MIRI during PCI,and results of creatine kinase-MB isoenzyme(CK-MB),cardiac troponin I(cTnI)and cardiac ultrasonography based on index of microcirculatory resistance(caIMR)of coronary angiography(CAG)after PCI for 24 h,48 h and 1 week.Results The incidence of arrhythmia due to MIRI during PCI was significantly lower in combined thrombolysis group than that in control group(10.00%vs.26.00%,P=0.037).The postoperative caIMR value had statistical difference between 2 groups(22.25±1.35 U vs.42.46±2.15 U,P=0.021).After PCI for 24 h,the increase value of cTnI[(38.15±8.65)μg/L vs.(49.22±9.18)μg/L,P=0.022]and CK-MB[CK-MB,(100.26±42.23)μg/L vs.(137.34±66.15)μg/L,P=0.047]were lower in combined thrombolysis group than those in control group.After PCI for 48 h,the decreasing trend of cTnI(12.01±5.03 μg/L vs.23.68±7.26 μg/L,P=0.005)and CK-MB(34.22±3.27 μg/L vs.49.33±12.23 μg/L,P=0.042)were superior in combined thrombolysis group to those in control group.There was no statistical difference in hospital mortality between 2 groups(2.00%vs.4.00%).There was no death case in 2 groups during 3-month follow-up period.The attack number of angina pectoris was less in combined thrombolysis group to that in control group(8.00%vs.22.00%).There were no statistical differences in other observation indicators between 2 groups(P＞0.05),including heart failure,mechanical complications,left ventricular ejection fraction(LVEF)and mortality.Conclusion The therapy of emergency PCI combined with TNK-tPA is superior to conventional PCI in STEMI patients.
Keywords：Acute ST-segment elevation myocardial infarctionPercutaneous coronary interventionTenecteplaseMyocardial ischemia-reperfusion injury
Publication Date：2025-06-20
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 731-735 )