Effect of thrombus aspiration during emergent percutaneous coronary intervention on myocardial perfusion and cardiac function in patients with non-ST-elevation myocardial infarction

doi:10.3760/cma.j.issn.1673-4777.2015.06.004

Abstract：Objective To explore the effect of thrombus aspiration during emergent percutaneous coronary intervention (PCI) on myocardial perfusion and cardiac function in patients with non-ST-elevation myocardial infarction (NSTEMI).Methods NSTEMI patients undergoing emergent PCI from January 2013 to July 2014 were enrolled and randomly divided into thrombus aspiration group which was given thrombus aspiration before stent implantation during PCI,and non-thrombus aspiration group which was given stent implantation only during PCI.The thrombolysis in myocardial infarction (TIMI) blood flow classification and corrected TIMI frame count (CTFC) immediately after operation were used to assess myocardial perfusion and echocardiography 1 week after operation was used to measure the cardiac function.The major adverse cardiac events in hospital were observed.Results A total of 82 patients were enrolled,and there were 41 cases in thrombus aspiration group and 41 cases in non-thrombus aspiration group.In thrombus aspiration group the ratio of TIMI grade 3 was higher,the ratio of TIMI grade 2 and 0-1 were lower compare with that in non-thrombus aspiration group [92.7％ (38/41) vs 58.5％ (24/41),4.9％ (2/41)vs26.8％ (11/41),2.4％ (1/41)vs 14.6％ (6/41),allP＜0.05];the CTFC of thrombus aspiration group was less than that of non-thrombus aspiration group with a significant difference [(28 ±5) frames vs (39 ± 5) frames,P ＜ 0.01].One week after PCI,the left ventricular ejection fraction was obviously higher and the left ventricular end-diastolic diameter was obviously smaller in thrombus aspiration group,compared with those in non-thronbus aspiration group [(57 ±10)％ vs (48 ±8)％,(50 ±5) mm vs (54 ±5) mm,both P ＜0.01].No major adverse cardiac events in hospital occurred in both groups.Conclusions Thrombus aspiration can effectively clear the microthrombus,improve the myocardial perfusion and cardiac function during PCI in NSTEMI patients,without increasing the incidence of major adverse cardiac events.