[The efficacy of percutaneous coronary intervention combined percutaneous thrombectomy on coronary thrombotic lesions in patients with acute myocardial infarction].

OBJECTIVE

To evaluate the efficacy of percutaneous coronary intervention (PCI) combined percutaneous thrombectomy on coronary thrombotic lesions in patients with acute myocardial infarction (AMI).

METHODS

PCI were performed in 56 patients with AMI and positive coronary thrombus shown by angiography and these patients were randomly divided into PCI therapy group (n = 28) and PCI combined percutaneous thrombectomy group (n = 28). Real-time myocardial contrast echocardiography (RT-MCE) was performed at 24h and 1 week after PCI. Contrast score index (CSI), regional wall motion score index (WMSI), endocardial length of contrast defect (CDL), and wall motion abnormality (WML) were calculated. The plasma level of hs-CRP was measured by immunonephelometry. The plasma concentration of N-terminal proB-type natriuretic peptide (NT-proBNP) and matrix metalloproteinase-9 (MMP-9) were detected by enzyme-linked immunosorbent assay (ELISA).

RESULTS

CSI, WMSI, CDL and WML at 24 hours and 1 week post procedure as well as the levels of hs-CPR and NT-proBNP at 1 week post procedure [(4.56 +/- 1.98) mg/L vs. (5.96 +/- 2.03) mg/L, P < 0.05; (544.7 +/- 185.3) pmol/L vs. (897.6 +/- 215.9) pmol/L, P < 0.01] were significantly lower in PCI combined percutaneous thrombectomy group than those in PCI group in various time points. There were no differences in the plasma level of MMP-9 between the two groups [(672.7 +/- 175.9) microg/L vs. (609.6 +/- 196.5) microg/L, P > 0.05] at 1 week after PCI.

CONCLUSIONS

PCI combined percutaneous thrombectomy can significantly reduce no-reflow phenomenon, improve microcirculation and myocardial dysfunction. Thus PCI combined percutaneous thrombectomy is a feasible therapy in patients with AMI.