Objective To compare the effects and complications of facilitated PCI and primary PCI in AMI patients for probe the feasibility and safety of the facilitated PCI via transradial artery approach.
Methods Total of 94 first-time AMI patients were randomised to group A (facilitated PCI group, n=36) and group B (primary PCI group, n=58). In group A, rt-PA 50 mg thrombolytic treatment, then transferred to catherlab for CAG and PCI at once. In group B, the patients received primary PCI via transradial artery approach. In each group, recorded detail clinical information. Recorded LVEDP and left ventricular wall movement scores through LVG. All patients received ERNA and MIBI MPI in 1 week after PCI to evaluate the heart function and myocardial infarction area.
Results There was no significant differences about baseline data between two groups. The patients got reperfusion about 3 h earlier than group B, and patients with TIMI 3 grade flow were more than group B before (p<0.01) and after PCI (p<0.05). No-reflow was fewer in group A (p<0.05). And success rate of PCI was higher in the group A (p<0.05). Myocardial perfusion was better in the group A, patients with TMP beyond 2 grade were more than group B (p<0.05). myocardial infarction area was smaller in the group A (p<0.01). The peak of CK and CK-MB were much lower in the group A than group B (p<0.01, respectively). The ventricular wall movement Cortina scores and the incidence of ventricular aneurysms were lower in the group A than group B (P<0.05, respectively). LVEDP was lower in group A (p<0.05), And the LVEF, left ventricular peak ejection rate, left peak filling rate in group A were higher than group B (p<0.01, respectively), and left ventricular time to peak ejection rate, left ventricular time to peak filling rate were lower in the group A (p<0.01, respectively).
Conclusions The facilitated PCI via transradial artery approach has the benefit on the reduction of infarction area and protection of left ventricular function.