Effect of one-stage stent implantation and delayed stent implantation on QTc dispersion and myocardial perfusion in patients with high thrombotic load acute myocardial infarction

Xiaorui Li, Jingxian Liu^*

Cardiology Department of Elderly, First Affiliated Hospital of Kunming Medical University, Kunming, 650000, China

Objective: The paper aimed to investigate the effects of primary stent implantation and delayed stent implantation on QTc dispersion and myocardial perfusion in patients with acute myocardial infarction with a high thrombotic load. 

Methods: A total of 80 patients with acute myocardial infarction (AMI) with a high thrombus burden were selected as the research subjects. According to whether the stent was implanted immediately after opening the vessel, they were divided into a Primary stent implantation group and delayed stent implantation group (40 cases in each group). A total of 40 patients with chest pain but normal coronary angiography was selected as the control group. The general conditions of the patients were observed and recorded, and the preoperative and postoperative QTc dispersion, myocardial perfusion (TIMI blood grading, thrombosis score), PCI status, and major postoperative adverse cardiovascular events (MACE) were compared in each group. 

Results: In both the Primary stent implantation group and the delayed stent implantation group, postoperative QTc dispersion of AMI patients was significantly reduced, the TIMI3 blood flow proportion was increased, and the thrombosis score was reduced; further, the improvement effect was more obvious in the delayed group (P<0.05). The number of stent placement cases, average number of stents, and also diameter and length of stents in the delayed group were significantly lower than those in the primary stent implantation group, with statistically significant differences (P<0.05). The incidence of MACE in the in-hospital and delayed groups within 1 year after surgery was much lower than that in the Primary group (P<0.05). 

Conclusion: Delayed stent implantation after vascular opening in AMI patients was beneficial in reducing QTc dispersion and improving myocardial perfusion; thus, it helps achieve a better prognosis effect, which is better than Primary stent implantation.