Clinical efficacy of the combination of alirocumab and percutaneous coronary intervention in treating ST-segment elevation myocardial infarction and its impact on the TIMI flow classification and prognosis
Objective To investigate the clinical efficacy of alirocumab combined with percutaneous coronary intervention(PCI)in the treatment of ST-segment elevation myocardial infarction(STEMI),as well as its impact on the thrombolysis in myocardial infarction(TIMI)flow grade and prognosis.Methods A total of 118 STEMI patients admit-ted to the Second People's Hospital of Jiaozuo City from March 2022 to October 2023 were selected as the research sub-jects and randomly divided into a control group and a study group according to a random number table method,with 59 cas-es in each group.Patients in the control group underwent routine PCI treatment,while patients in the study group under-went PCI combined with alirocumab.Both groups of patients were treated continuously until 6 months after PCI.The therapeutic effects,changes in cardiac function(cardiac index[CI],left ventricular end-diastolic diameter[LVEDD],car-diac output[CO],left ventricular ejection fraction[LVEF],left ventricular end-systolic diameter[LVESD]),blood lipids(low-density lipoprotein cholesterol[LDL-C],total cholesterol[TC]),inflammatory factors(interleukin-6[IL-6],matrix metalloproteinase-9[MMP-9]),and TIMI flow classification were compared between the two groups before and after treatment.Additionally,the occurrence of major adverse cardiovascular events(MACE)during the treatment period was analyzed.Results The total effective rate of treatment in the study group was 91.53%,significantly higher than 76.27%in the control group,with a statistically significant difference(P<0.05).After treatment,the study group demonstrated significantly lower levels of LVESD and LVEDD compared to the control group:(34.29±3.61)mm vs(37.60±4.13)mm,(46.29±4.11)mm vs(50.63±4.72)mm,respectively,P<0.05.The levels of CI,LVEF,and CO in the study group were(3.55±0.48)L/(min·m2),(51.28±7.06)%,and(4.82±0.53)L/min,respectively,which were significantly higher than(3.21±0.47)L/(min·m2),(55.31±7.23)%,and(4.27±0.48)L/min in the control group(P<0.05).After treatment,the levels of LDL-C,IL-6,TC,and MMP-9 in the study group were(1.74±0.42)mmol/L,(14.31±4.27)ng/L,(3.54±0.69)mmol/L,and(35.16±5.20)ng/mL,respectively,which were significantly lower than(2.13±0.46)mmol/L,(17.52±4.83)ng/L,(4.16±0.73)mmol/L,and(39.43±5.76)ng/mL in the control group(P<0.05).After treatment,the TIMI flow classifica-tion of patients in the study group was also higher than that in the control group,with a statistically significant difference(P<0.05).The incidence of MACE during the treatment period in the study group was 5.08%,significantly lower than 18.64%in the control group(P<0.05).Conclusion Alirocumab combined with PCI is superior to conventional PCI treatment in the treatment of STEMI.Alirocumab combined with PCI can reduce the patient's blood lipid levels,improve cardiac function,inhibit inflammatory responses,increase coronary blood flow,and improve the patient's prognosis.
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