Care of Patients With Heart DiseaseComparison of different strategies for acute ST-segment elevation myocardial infarction with high thrombus burden in clinical practice: Symptom-free outcome at one year

- We evaluate the clinical effects of different strategies for preventing coronary microvascular obstruction.
- The strategies include intracoronary injection of a Glycoprotein (GP) IIb/IIIa inhibitors and installation of a distal protective device, in STEMI patients with a high thrombus-burden plaque.
- We explore the eradication for post-MI angina if we perform these strategies to prevent coronary microvascular obstruction.
- We provide different strategies for prevention of coronary microvascular obstruction and the eradication for post-MI angina.

ObjectiveThe aim of this study was to evaluate the clinical effects of different strategies for preventing coronary microvascular obstruction in ST elevation myocardial infarction (STEMI) patients with a high thrombus-burden plaque.MethodsBetween January, 2007 and December, 2012, 354 patients suffering from STEMI with high thrombus-burden were enrolled and divided into three groups as the first group received a GP IIb/IIIa inhibitor, and the second group received a distal protective device, and the third group was treated with primary PCI alone.ResultsA high percentage of patients in the GP IIb/IIIa inhibitor (96.8% and 90.5%), distal protective device (99.3% and 87.6%) had better thirty-day and one-year symptom-free outcomes when compared with PCI only group (91.6% and 65.6%) (P = 0.008 and P < 0.001; respectively).ConclusionsTreatment with intracoronary GP IIb/IIIa inhibitor injection or distal protection device to prevent coronary microvascular obstruction was demonstrated to increase the occurrences of thirty-day and one-year symptom-free outcomes; thus, these treatments can help decrease post-MI medical care costs.