Background No-reflow after emergency percutaneous coronary intervention （PCI） for acute ST segment elevation myocardial infarction （STEMI） is related to the severe prognosis. The aim of this study was to evaluate ...Background No-reflow after emergency percutaneous coronary intervention （PCI） for acute ST segment elevation myocardial infarction （STEMI） is related to the severe prognosis. The aim of this study was to evaluate the efficacy of Tongxinluo, a traditional Chinese medicine, on no-reflow and the infarction area after emergency PCI for STEMI.Methods A total of 219 patients （female 31, 14%） undergoing emergency PCI for STEMI from nine clinical centers were consecutively enrolled in this randomized, double-blind, placebo-controlled, multicenter clinical trial from January 2007 to May 2009. All patients were randomly divided into Tongxinluo group （n=108） and control group （n=111）, given Tongxinluo or placebo in loading dose 2.08 g respectively before emergency PCI with asprin 300 mg and clopidogrel 300 mg together, then 1.04 g three times daily for six months after PCI. The ST segment elevation was recorded by electrocardiogram at hospitalization and 1, 2, 6, 12, 24 hours after coronary balloon dilation to evaluate the myocardial no-flow; myocardial perfusion scores of 17 segments were evaluated on day 7 and day 180 after STEMI with static single-photon emission computed tomography （SPECT） to determine the infarct area.Results There was no statistical significance in sex, age, past history, chest pain, onset-to-reperfusion time, Killip classification, TIMI flow grade just before and after PCI, either in the medication treatment during the follow up such as statin, β-blocker, angiotensin converting enzyme inhibitor （ACEI） or angiotensin receptor blocker （ARB） between two groups. There was significant ST segment restoration in Tongxinluo group compared to the control group at 6 hours （（-0.22±0.18） mV vs. （-0.18±0.16） mV, P=0.0394）, 12 hours （（-0.24 ± 0.18） mV vs. （-0.18±0.15） mV, P=0.0158） and 24 hours （（-0.27±0.16） mV vs. （-0.20±0.16） mV, P=0.0021） reperfusion; and the incidence of myocardial no-reflow was also reduced significantly at 24-hour rep展开更多
BACKGROUND: The treatment of acute myocardial infarction(AMI) is thought to restore antegrade blood flow in the infarct-related artery(IRA) and minimize ischemic damage to the myocardium as soon as possible. The prese...BACKGROUND: The treatment of acute myocardial infarction(AMI) is thought to restore antegrade blood flow in the infarct-related artery(IRA) and minimize ischemic damage to the myocardium as soon as possible. The present study aimed to identify possible clinical predictors for no-refl ow in patients with AMI after primary percutaneous coronary intervention(PCI).METHODS: A total of 312 consecutive patients with AMI who had been treated from January 2008 to December 2010 at the Cardiology Department of East Hospital, Tongji University School of Medicine were enrolled in this study. Inclusion criteria were:(i) patients underwent successfully primary PCI within 12 hours after the appearance of symptoms; or(ii) patients with ischemic chest pain for more than 12 hours after a successful primary PCI within 24 hours after appearance of symptoms. Exculsion criteria were:(i) coronary artery spasm;(ii) diameter stenosis of the culprit lesion was ≤50% and coronary blood f low was normal;(iii) patients with severe left main coronary or multivessel disease, who had to require emergency revascularization. According to thrombolysis in myocardial infarction(TIMI), the patients were divided into a reflow group and a no-reflow group. The clinical data, angiography f indings and surgical data were compared between the two groups. Univariate and multivariate logistic regressions were used to determine the predictors for no-ref low.RESULTS: Fifty-four(17.3%) of the patients developed NR phenomenon after primary PCI. Univariate analysis showed that age, time from onset to reperfusion, systolic blood pressure(SBP) on admission, Killip class of myocardial infarction, intra-aortic balloon pump(IABP) use before primary PCI, TIMI flow grade before primary PCI, type of occlusion, thrombus burden on baseline angiography, target lesion length, reference luminal diameter and method of reperfusion were correlated with no-reflow(P<0.05 for all). Multiple logistic regression analysis identified that age >65 years [OR=1.470, 95% confi dence interv展开更多
Background Successful revascularization of coronary artery disease, especially ST-elevation myocardial infarction （STEMI）, does not always mean optimal myocardial reperfusion in a portion of patients because of no-r...Background Successful revascularization of coronary artery disease, especially ST-elevation myocardial infarction （STEMI）, does not always mean optimal myocardial reperfusion in a portion of patients because of no-reflow phenomenon. We hypothesized that statins might attenuate the incidence of myocardial no-reflow when used before percutaneous coronary intervention （PCI）. The purpose of this study was to summarize the evidence of pre-procedural statin therapy to reduce myocardial no-reflow after PCI. Methods We searched the MEDLINE, Cochrane, and clinicaltrials.gov databases from inception to October 2012 for clinical trials that examined statin therapy before PCI. We required that studies initiated statins before PCI and reported myocardial no-reflow. A DerSimonian-Laird model was used to construct random-effects summary risk ratios. Results In all, 7 studies with 3086 patients met our selection criteria. The use of pre-procedural statins significantly reduced post-procedural no-reflow by 4.2% in all PCI patients （risk ratio （RR） 0.56, 95% confidence interval （CI） 0.35 to 0.90, P=0.016）, and attenuated by 5.0% in non-STEMI patients （RR 0.41, 95% CI 0.18 to 0.94, P=0.035）. This benefit was mainly observed in the early or acute intensive statin therapy populations （RR 0.43, 95% CI 0.26 to 0.71, P=0.001）. Conclusions Acute intensive statin therapy before PCI significantly reduces the hazard of post-procedural no-reflow phenomenon. The routine use of statins before PCI should be considered.展开更多
Objective： To evaluate whether liposomal prostaglandin E1 （lipo-PGE1） can decrease reperfusion no-reflow in a catheter-based porcine model of acute myocardial infarction （AMI）. Methods： Twenty-two male Chinese m...Objective： To evaluate whether liposomal prostaglandin E1 （lipo-PGE1） can decrease reperfusion no-reflow in a catheter-based porcine model of acute myocardial infarction （AMI）. Methods： Twenty-two male Chinese mini-swines were randomized into three groups： six in a sham-operation group, and eight each in the control and lipo-PGE1 groups. The distal part of the left anterior descending coronary artery （LAD） in the latter two groups was completely occluded for 2 h, and then reperfused for 3 h. Lipo-PGE1 （1 pg/kg） was injected 10 min before LAD occlusion until reperfusion for 1 h in the lipo-PGE1 group. Hemodynamic data and proinflammatory cytokines were examined before AMI, 2 h after occlusion, and 1, 2, and 3 h after reperfusion. Myocardial contrast echocardiography （MCE） and double staining were performed to evaluate the myocardial no-reflow area （NRA）. Results： Left ventricular systolic pressure and end-diastolic pressure significantly improved in the lipo-PGE1 group after reperfusion compared with the control group and also 2 h after AMI （P〈0.05 for both）. MCE and double staining both showed that lipo-PGE1 decreased reperfusion NRA after AMI （P〈0.05, P〈0.01）. Lipo-PGE1 decreased serum interleukin-6 （IL-6） and tumor necrosis factor-a （TNF-a） after myocardial infarction reperfusion （P〈0.05 for both）. Conclusions： Lipo-PGE1 is cardioprotective in our porcine model of myocardial infarction reperfusion no-reflow, decreasing NRA and attenuating the inflammatory response.展开更多
Background No-reflow phenomenon during percutaneous coronary intervention （PCI） for acute myocardial infarction （AMI） is a predictive factor of continuous myocardial ischemia, ventricular remodeling and cardiac dy...Background No-reflow phenomenon during percutaneous coronary intervention （PCI） for acute myocardial infarction （AMI） is a predictive factor of continuous myocardial ischemia, ventricular remodeling and cardiac dysfunction, which is closely associated with a worse prognosis. This study aimed to evaluate intracoronary nitroprusside in the prevention of the no-reflow phenomenon in AMI.Methods Ninety-two consecutive patients with AMI, who underwent primary PCI within 12 hours of onset, were randomly assigned to 2 groups： intracoronary administration of nitroprusside （group A, n=46）, intracoronary administration of nitroglycerin （group B, n=46）. The angJographic results were observed. The real-time myocardial contrast echocardiography （RT-MCE）, including contrast score index （CSI）, wall motion score index （WMSI）, transmural contrast defect length （CDL） and serious WM abnormal length （WML） were recorded at 24 hours and 1 week post-PCI. High sensitivity C-reactive protein （Hs-CRP） was examined by immune rate nephelometry. N-terminal prohormone brain natriuretic peptide （NT-proBNP） was tested with enzyme-linked immunosorbent assay. Patients were followed up for six months. Major adverse cardiac events （MACE） were recorded. Results The incidence of final TIMI-3 flow in group A was much higher than that in Group B （P 〈0.05）, final corrected TIMI frame count （cTFC） in group A decreased significantly than that in group B （P 〈0.01）. The CSI, CDL/LV length, WMSI and WL/LV length in group A were significantly lower than that in group B （P 〈0.01）. Levels of Hs-CRP and NT-proBNP at 1 week post-PCI decreased significantly in group A than that in group B （P 〈0.01）. Patients were followed up for 6 months and the incidence of MACE in group A was significantly lower than that in group B （P〈0.05）.Conclusion Intracoronary nitroprusside can improve myocardial microcirculation, leading to the decrease of the incidence of no-reflow phenomenon and better pr展开更多
目的探讨单个导联 ST 段回落程度不良对临床预后的影响并筛选其相关的预测因素,以早期识别高危患者,从而积极防止心肌无复流的发生。方法回顾性收集964例急性 ST 段抬高心肌梗死行急诊 PCI 患者的临床资料、冠状动脉造影资料与心电图,...目的探讨单个导联 ST 段回落程度不良对临床预后的影响并筛选其相关的预测因素,以早期识别高危患者,从而积极防止心肌无复流的发生。方法回顾性收集964例急性 ST 段抬高心肌梗死行急诊 PCI 患者的临床资料、冠状动脉造影资料与心电图,分析单导联 ST 段回落不良患者的临床特征及住院期间主要不良心脏事件(MACE)发生的差异,应用统计学软件筛选 ST 段回落不良的预测因素。结果急诊 PCI 后梗死相关血管(IRA)前向血流达到 TIMIⅢ级而心电图 ST 段回落小于50%者占27.42%。ST 段无回落组其年龄更大、前壁心肌梗死比率更多、心功能分级≥Killip 2级更多、肌酸激酶同工酶(CK-MB)峰值更高、糖尿病比率更多、纤维蛋白原浓度更大、C 反应蛋白(CRP)升高比率更多、人院白细胞水平更高、胸痛至急诊室时间更长、冠状动脉病变更复杂,临床预后比较显示,ST 段无回落组平均住院日更长,左室射血分数更低,梗死后心绞痛发生率更高,术后 IRA血流 TIMIⅢ级达标率更低,心力衰竭、恶性心律失常、心脏性死亡以及总的 MACE 事件发生率更高(25.5%对4.4%,P<0.001)。Cox 回归分析显示 ST 段回落不良是住院期间发生 MACE 的独立预测因素之一(RR=3.33,P<0.001)。Logistic 回归分析显示 ST 段回落不良的预测因素有前壁心肌梗死、入院心功能分级2级以上(Killip)、胸痛至急诊室时间(h)、入院白细胞计数。结论 ST 段抬高的心肌梗死急诊 PCI 后 IRA 达到 TIMIⅢ级血流者仍会有近1/3的患者其心电图 ST 段回落小于50%,反映其心肌组织水平灌注不良,这些患者住院期间发生 MACE 的风险明显升高。前壁心肌梗死、入院心功能较差、入院白细胞计数较高、胸痛至急诊室时间较长等均与 ST 段回落不良高度相关,对具备以上情况的高危患者应采取更加积极的干预方案。展开更多
Objective To observe the effect of Danhong injection(DI)in patients with acute ST-segment elevation myocardial infarction(STEMI)at a high risk of no-reflow(NR)during primary percutaneous coronary intervention(PCI).Met...Objective To observe the effect of Danhong injection(DI)in patients with acute ST-segment elevation myocardial infarction(STEMI)at a high risk of no-reflow(NR)during primary percutaneous coronary intervention(PCI).Methods Patients were placed in a DI group and control group.The DI group was given DI and the control group was given physiologic saline.The administration lasted 4 to 6 days in both groups after PCI.Cardiac magnetic resonance(CMR)was carried out during the perioperative period(7±2 days).The primary endpoint of the study was myocardial infarct size(IS)imaged on delayed-enhancement CMR.The secondary endpoint was major adverse cardiac events observed 6 months after PCI.Results In total,160 high-risk NR patients were enrolled,and 110 patients completed the CMR examination.According to postoperative CMR,the Myocardial Salvage Index and left ventricular ejection fraction were higher in the DI group(0.57±0.13 vs.0.48±0.17,P<0.01;49.3%±6.9%vs.46.2%±7.7%,P=0.03,respectively),whereas the IS was lower(19.7%±5.6%vs.22.2%±6.5%,P=0.04),compared with that in the control group.These differences were observed to be significant.After 6 months,the prevalence of major adverse cardiac events in the DI group decreased compared with that in the control group,but the differences were not observed to be significant(P>0.05).Conclusion The application of DI can reduce the myocardial infarct size in STEMI patients at a high risk of NR during primary PCI.展开更多
文摘Background No-reflow after emergency percutaneous coronary intervention （PCI） for acute ST segment elevation myocardial infarction （STEMI） is related to the severe prognosis. The aim of this study was to evaluate the efficacy of Tongxinluo, a traditional Chinese medicine, on no-reflow and the infarction area after emergency PCI for STEMI.Methods A total of 219 patients （female 31, 14%） undergoing emergency PCI for STEMI from nine clinical centers were consecutively enrolled in this randomized, double-blind, placebo-controlled, multicenter clinical trial from January 2007 to May 2009. All patients were randomly divided into Tongxinluo group （n=108） and control group （n=111）, given Tongxinluo or placebo in loading dose 2.08 g respectively before emergency PCI with asprin 300 mg and clopidogrel 300 mg together, then 1.04 g three times daily for six months after PCI. The ST segment elevation was recorded by electrocardiogram at hospitalization and 1, 2, 6, 12, 24 hours after coronary balloon dilation to evaluate the myocardial no-flow; myocardial perfusion scores of 17 segments were evaluated on day 7 and day 180 after STEMI with static single-photon emission computed tomography （SPECT） to determine the infarct area.Results There was no statistical significance in sex, age, past history, chest pain, onset-to-reperfusion time, Killip classification, TIMI flow grade just before and after PCI, either in the medication treatment during the follow up such as statin, β-blocker, angiotensin converting enzyme inhibitor （ACEI） or angiotensin receptor blocker （ARB） between two groups. There was significant ST segment restoration in Tongxinluo group compared to the control group at 6 hours （（-0.22±0.18） mV vs. （-0.18±0.16） mV, P=0.0394）, 12 hours （（-0.24 ± 0.18） mV vs. （-0.18±0.15） mV, P=0.0158） and 24 hours （（-0.27±0.16） mV vs. （-0.20±0.16） mV, P=0.0021） reperfusion; and the incidence of myocardial no-reflow was also reduced significantly at 24-hour rep
文摘BACKGROUND: The treatment of acute myocardial infarction(AMI) is thought to restore antegrade blood flow in the infarct-related artery(IRA) and minimize ischemic damage to the myocardium as soon as possible. The present study aimed to identify possible clinical predictors for no-refl ow in patients with AMI after primary percutaneous coronary intervention(PCI).METHODS: A total of 312 consecutive patients with AMI who had been treated from January 2008 to December 2010 at the Cardiology Department of East Hospital, Tongji University School of Medicine were enrolled in this study. Inclusion criteria were:(i) patients underwent successfully primary PCI within 12 hours after the appearance of symptoms; or(ii) patients with ischemic chest pain for more than 12 hours after a successful primary PCI within 24 hours after appearance of symptoms. Exculsion criteria were:(i) coronary artery spasm;(ii) diameter stenosis of the culprit lesion was ≤50% and coronary blood f low was normal;(iii) patients with severe left main coronary or multivessel disease, who had to require emergency revascularization. According to thrombolysis in myocardial infarction(TIMI), the patients were divided into a reflow group and a no-reflow group. The clinical data, angiography f indings and surgical data were compared between the two groups. Univariate and multivariate logistic regressions were used to determine the predictors for no-ref low.RESULTS: Fifty-four(17.3%) of the patients developed NR phenomenon after primary PCI. Univariate analysis showed that age, time from onset to reperfusion, systolic blood pressure(SBP) on admission, Killip class of myocardial infarction, intra-aortic balloon pump(IABP) use before primary PCI, TIMI flow grade before primary PCI, type of occlusion, thrombus burden on baseline angiography, target lesion length, reference luminal diameter and method of reperfusion were correlated with no-reflow(P<0.05 for all). Multiple logistic regression analysis identified that age >65 years [OR=1.470, 95% confi dence interv
基金This study was supported by grants from National Basic Research Program （973 Program） in China （No. 2011CB503901 and 2012CB518602）, and China Postdoctoral Science Foundation （No. 2012M510355）.
文摘Background Successful revascularization of coronary artery disease, especially ST-elevation myocardial infarction （STEMI）, does not always mean optimal myocardial reperfusion in a portion of patients because of no-reflow phenomenon. We hypothesized that statins might attenuate the incidence of myocardial no-reflow when used before percutaneous coronary intervention （PCI）. The purpose of this study was to summarize the evidence of pre-procedural statin therapy to reduce myocardial no-reflow after PCI. Methods We searched the MEDLINE, Cochrane, and clinicaltrials.gov databases from inception to October 2012 for clinical trials that examined statin therapy before PCI. We required that studies initiated statins before PCI and reported myocardial no-reflow. A DerSimonian-Laird model was used to construct random-effects summary risk ratios. Results In all, 7 studies with 3086 patients met our selection criteria. The use of pre-procedural statins significantly reduced post-procedural no-reflow by 4.2% in all PCI patients （risk ratio （RR） 0.56, 95% confidence interval （CI） 0.35 to 0.90, P=0.016）, and attenuated by 5.0% in non-STEMI patients （RR 0.41, 95% CI 0.18 to 0.94, P=0.035）. This benefit was mainly observed in the early or acute intensive statin therapy populations （RR 0.43, 95% CI 0.26 to 0.71, P=0.001）. Conclusions Acute intensive statin therapy before PCI significantly reduces the hazard of post-procedural no-reflow phenomenon. The routine use of statins before PCI should be considered.
基金Project (No. 03III02) supported by the Capital Medical Development Research Fund of China
文摘Objective： To evaluate whether liposomal prostaglandin E1 （lipo-PGE1） can decrease reperfusion no-reflow in a catheter-based porcine model of acute myocardial infarction （AMI）. Methods： Twenty-two male Chinese mini-swines were randomized into three groups： six in a sham-operation group, and eight each in the control and lipo-PGE1 groups. The distal part of the left anterior descending coronary artery （LAD） in the latter two groups was completely occluded for 2 h, and then reperfused for 3 h. Lipo-PGE1 （1 pg/kg） was injected 10 min before LAD occlusion until reperfusion for 1 h in the lipo-PGE1 group. Hemodynamic data and proinflammatory cytokines were examined before AMI, 2 h after occlusion, and 1, 2, and 3 h after reperfusion. Myocardial contrast echocardiography （MCE） and double staining were performed to evaluate the myocardial no-reflow area （NRA）. Results： Left ventricular systolic pressure and end-diastolic pressure significantly improved in the lipo-PGE1 group after reperfusion compared with the control group and also 2 h after AMI （P〈0.05 for both）. MCE and double staining both showed that lipo-PGE1 decreased reperfusion NRA after AMI （P〈0.05, P〈0.01）. Lipo-PGE1 decreased serum interleukin-6 （IL-6） and tumor necrosis factor-a （TNF-a） after myocardial infarction reperfusion （P〈0.05 for both）. Conclusions： Lipo-PGE1 is cardioprotective in our porcine model of myocardial infarction reperfusion no-reflow, decreasing NRA and attenuating the inflammatory response.
文摘Background No-reflow phenomenon during percutaneous coronary intervention （PCI） for acute myocardial infarction （AMI） is a predictive factor of continuous myocardial ischemia, ventricular remodeling and cardiac dysfunction, which is closely associated with a worse prognosis. This study aimed to evaluate intracoronary nitroprusside in the prevention of the no-reflow phenomenon in AMI.Methods Ninety-two consecutive patients with AMI, who underwent primary PCI within 12 hours of onset, were randomly assigned to 2 groups： intracoronary administration of nitroprusside （group A, n=46）, intracoronary administration of nitroglycerin （group B, n=46）. The angJographic results were observed. The real-time myocardial contrast echocardiography （RT-MCE）, including contrast score index （CSI）, wall motion score index （WMSI）, transmural contrast defect length （CDL） and serious WM abnormal length （WML） were recorded at 24 hours and 1 week post-PCI. High sensitivity C-reactive protein （Hs-CRP） was examined by immune rate nephelometry. N-terminal prohormone brain natriuretic peptide （NT-proBNP） was tested with enzyme-linked immunosorbent assay. Patients were followed up for six months. Major adverse cardiac events （MACE） were recorded. Results The incidence of final TIMI-3 flow in group A was much higher than that in Group B （P 〈0.05）, final corrected TIMI frame count （cTFC） in group A decreased significantly than that in group B （P 〈0.01）. The CSI, CDL/LV length, WMSI and WL/LV length in group A were significantly lower than that in group B （P 〈0.01）. Levels of Hs-CRP and NT-proBNP at 1 week post-PCI decreased significantly in group A than that in group B （P 〈0.01）. Patients were followed up for 6 months and the incidence of MACE in group A was significantly lower than that in group B （P〈0.05）.Conclusion Intracoronary nitroprusside can improve myocardial microcirculation, leading to the decrease of the incidence of no-reflow phenomenon and better pr
文摘目的探讨单个导联 ST 段回落程度不良对临床预后的影响并筛选其相关的预测因素,以早期识别高危患者,从而积极防止心肌无复流的发生。方法回顾性收集964例急性 ST 段抬高心肌梗死行急诊 PCI 患者的临床资料、冠状动脉造影资料与心电图,分析单导联 ST 段回落不良患者的临床特征及住院期间主要不良心脏事件(MACE)发生的差异,应用统计学软件筛选 ST 段回落不良的预测因素。结果急诊 PCI 后梗死相关血管(IRA)前向血流达到 TIMIⅢ级而心电图 ST 段回落小于50%者占27.42%。ST 段无回落组其年龄更大、前壁心肌梗死比率更多、心功能分级≥Killip 2级更多、肌酸激酶同工酶(CK-MB)峰值更高、糖尿病比率更多、纤维蛋白原浓度更大、C 反应蛋白(CRP)升高比率更多、人院白细胞水平更高、胸痛至急诊室时间更长、冠状动脉病变更复杂,临床预后比较显示,ST 段无回落组平均住院日更长,左室射血分数更低,梗死后心绞痛发生率更高,术后 IRA血流 TIMIⅢ级达标率更低,心力衰竭、恶性心律失常、心脏性死亡以及总的 MACE 事件发生率更高(25.5%对4.4%,P<0.001)。Cox 回归分析显示 ST 段回落不良是住院期间发生 MACE 的独立预测因素之一(RR=3.33,P<0.001)。Logistic 回归分析显示 ST 段回落不良的预测因素有前壁心肌梗死、入院心功能分级2级以上(Killip)、胸痛至急诊室时间(h)、入院白细胞计数。结论 ST 段抬高的心肌梗死急诊 PCI 后 IRA 达到 TIMIⅢ级血流者仍会有近1/3的患者其心电图 ST 段回落小于50%,反映其心肌组织水平灌注不良,这些患者住院期间发生 MACE 的风险明显升高。前壁心肌梗死、入院心功能较差、入院白细胞计数较高、胸痛至急诊室时间较长等均与 ST 段回落不良高度相关,对具备以上情况的高危患者应采取更加积极的干预方案。
基金supported by grant from the Capital health research and development of special project (2016-15011)
文摘Objective To observe the effect of Danhong injection(DI)in patients with acute ST-segment elevation myocardial infarction(STEMI)at a high risk of no-reflow(NR)during primary percutaneous coronary intervention(PCI).Methods Patients were placed in a DI group and control group.The DI group was given DI and the control group was given physiologic saline.The administration lasted 4 to 6 days in both groups after PCI.Cardiac magnetic resonance(CMR)was carried out during the perioperative period(7±2 days).The primary endpoint of the study was myocardial infarct size(IS)imaged on delayed-enhancement CMR.The secondary endpoint was major adverse cardiac events observed 6 months after PCI.Results In total,160 high-risk NR patients were enrolled,and 110 patients completed the CMR examination.According to postoperative CMR,the Myocardial Salvage Index and left ventricular ejection fraction were higher in the DI group(0.57±0.13 vs.0.48±0.17,P<0.01;49.3%±6.9%vs.46.2%±7.7%,P=0.03,respectively),whereas the IS was lower(19.7%±5.6%vs.22.2%±6.5%,P=0.04),compared with that in the control group.These differences were observed to be significant.After 6 months,the prevalence of major adverse cardiac events in the DI group decreased compared with that in the control group,but the differences were not observed to be significant(P>0.05).Conclusion The application of DI can reduce the myocardial infarct size in STEMI patients at a high risk of NR during primary PCI.
