The impact of enhanced external counterpulsation on coronary blood flow in patients with acute ST-segment elevation myocardial infarction after emergency PCI
Objective To analyze the impact of enhanced external counterpulsation(EECP)on coronary blood flow in patients with acute ST-segment elevation myocardial infarction(STEMI)after emergency percutaneous coronary intervention(PCI).Methods 74 patients with acute STEMI were studied and randomly divided into a study group(n=37)and a control group(n=37).Both groups underwent emergency PCI.The study group received postoperative EECP adjuvant treatment,while the control group received postoperative balloon wrapping but no EECP treatment.The following parameters between two groups were compared:aortic blood pressure[systolic blood pressure(SBP),diastolic blood pressure(DBP)]at different time points[immediately after PCI(t1),30 min after EECP/balloon wrapping(t2),and 5 min after cessation of EECP/balloon wrapping(t3)],corrected TIMI frame count(cTFC)at different time points[t1,t3],serum myocardial markers[N-terminal pro-brain natriuretic peptide(NT-proBNP),cardiac troponin I(cTnI),creatine kinase isoenzyme(CK-MB)]before and after surgery,adverse reactions and major adverse cardiac and cerebrovascular events(MACCEs).Results There was no significant difference in aortic SBP and DBP between the study group and the control group at t1 and t3(P>0.05).At t2,the study group had significantly lower SBP of(112.8±8.5)mm Hg(1 mm Hg=0.133 kPa)than(121.3±12.9)mm Hg of the control group,and significantly higher DBP of(81.3±9.0)mm Hg than(75.2±10.7)mm Hg of the control group(P<0.05).At t1,the cTFC of the study group and the control group were(34.6±14.3)and(33.2±12.9)frames,and there was no statistical difference(P>0.05).At t3,the study group had lower cTFC of(25.3±12.2)frames than(32.7±14.0)frames of the control group(P<0.05).There were no significant differences in serum NT-proBNP,CK-MB and cTnI levels between the two groups before surgery(P>0.05).Serum NT-proBNP levels were reduced in both groups at 2 h after surgery,and the study group was lower than the control group(P<0.05).There was no statistically significant difference in serum CK-MB and cTnI levels between the two groups at 2 h after surgery(P>0.05).There was no statistically significant difference in the incidence of adverse events and MACCEs between the two groups(P>0.05).Conclusion EECP can reduce slow flow and myocardial injury in patients with acute STEMI after emergency PCI,and has good safety.
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