Analysis of the Effects of PTCA Combined with Stent Implantation on Left Ventricular Remodeling in Patients with AMI
Objective To an alyze the effects of direct percutaneous transluminal coronary angioplasty(PTCA)combined with stent implantation on left ventricular remodeling in patients with acute myocardial infarction(AMI).Methods A retrospective analysis was conducted on the clinical data of 115 patients with AMI admitted to the hospital from February 2021 to December 2023.According to the time of PTCA combined with stent implantation,patients enrolled were divided into a treatment group and a control group.74 Patients in the treatment group received direct PTCA combined with stent implantation(i.e.PTCA combined with stent implantation within 2～10 hour after onset)treatment,while 41 patients in the control group received elective PTCA combined with stent implantation(i.e.PTCA combined with stent implantation within 7～13 day after onset)treatment.The levels of left ventricular remodeling indicators,myocardial injury markers,vascular endothelial growth factors,cardiac function indicators,neuroendocrine factors,and D-dimer(D-D)in the two groups were compared.Results Three months after surgery,there were increases in left ventricular ejection fraction(LVEF),and decreases in interventricular septal thickness(IVST),left ventricular end diastolic diameter(LVEDd),left ventricular end systolic diameter(LVESd),left ventricular mass index(LVMI)and left ventricular posterior wall thickness(LVPWT)in both groups.Moreover,all indicators in the treatment group were better than those in the control group(P＜0.05).Three months after surgery,the levels of cardiac troponin Ⅰ(cTnⅠ),creatine kinase isoenzyme(CK-MB),N-terminal pro B-type natriuretic peptide(NT-proBNP),D-D,endothelin-1(ET-1),plasma renin activity(PRA),aldosterone(ALD),angiotensin Ⅱ(AngⅡ),and norepinephrine(NE)in both groups were lower than before surgery,while nitric oxide(NO)levels were higher than before surgery.Moreover,all indicators in the treatment group were better than those in the control group(P＜0.05).Conclusion In the clinical treatment of patients with AMI,direct PTCA combined with stent implantation is more effective in inhibiting left ventricular remodeling compared to elective PTCA combined with stent implantation,which may be related to the former's advantages in improving myocardial ischemia,neuroendocrine,endothelial function and coagulation function in patients.
万方数据
维普
