PERCUTANEOUS CORONARY INTERVENTION FOR POOR CORONARY MICROCIRCULATION REPERFUSION OF PATIENTS WITH STABLE ANGINA PECTORIS

Abstract

Percutaneous coronary intervention (PCI) has been extensively applied to repair the forward flow ofdiseased coronary artery and can achieve significant curative results. However, some patients with acutemyocardial infarction (AMI) develop non-perfusion or poor perfusion of cardiac muscle tissue after PCI,which increases the incidence of cardiovascular events and the death rate. PCI can dredge narrowedor infarct-related artery (IRA) and thus induce full reperfusion of ischemic myocardium. It is foundin practice that some cases of AMI still have no perfusion or poor perfusion in myocardial tissue eventhough coronary angiography suggests opened coronary artery after PCI, which increases the incidence ofvascular events and mortality. Therefore, to explore the detailed mechanism of PCI in treating coronarymicrocirculation of patients with stable angina pectoris, we selected 140 patients with stable anginapectoris for PCI, observing the index of microcirculatory resistance (IMR) of descending branch andchanges of myocardial injury markers and left ventricular systolic function, and made a subgroup analysisbased on the correlation between clinical indexes, IMR and other variables of diabetic and non-diabeticpatients, PCI-related and non-PCI-related myocardial infarction patients. The results suggest that IMRof anterior descending branch after PCI was higher compared to that before PCI, and the difference wassignificant (P<0.05); creatine kinase-MB (CK-MB), myohemoglobin and high sensitive troponin T were allincreased after PCI, and the difference was also significant (P<0.05); brain natriuretic peptide (BNP) levelbecame higher after PCI, with significant difference (P<0.05); left ventricular ejection fraction (LVEF)declined after PCI, and the difference before and after PCI was statistically significant (P<0.05). Moreover,subgroup analysis results of the three groups all demonstrated statistically significant differences. PCI caneffectively increase microcirculatory resistance of patients with stable angina pectoris, especially thosewho develop both stable angina pectoris and diabetes. Patients with higher microcirculatory resistancebefore PCI are more likely to develop PCI-related myocardial infarction after PCI.