Comparative study on the efficacy and safety between immediate and selective PCI on STEMI patients with TIMI grade 3

【Objective】To evaluate the efficacy and safety between immediate and selective percutaneous coronary intervention(PCI) in patients with ST-segment elevation myocardial infarction(STEMI) with TIMI grade 3.【Methods】86 cases of patients with acute STEMI,which coronary angiography showed TIMI flow grade 3,were divided randomly into immediate PCI group(44 cases,PCI was implemented immediately when hospitalized) and selective PCI group(42 cases,PCI was implemented at 7～10 days after STEMI).The success rate of procedural implantation of stent,the incidence of intraoperative slow flow or no-reflow and adverse cardiovascular events during hospitalization,the hospitalized stay and left ventricular ejection fraction(LVEF) at 4 weeks after PCI were observed.【Results】The success rate of stent implantation in the selective PCI group was 100%,significantly higher than 88.64% in the immediate PCI group(P 0.05).The incidence of intra-operative slow flow or no-reflow in immediate PCI group was 11.36%,while no case was found in selective PCI group(P 0.05).The rate of the adverse cardiovascular events during hospitalization was 4.54% in immediate PCI group,while no event was found in the selective PCI group(P 0.05),but LVEF at 4 weeks after PCI and the hospitalized time were not significant different between the both groups(P 0.05).【Conclusions】The findings suggested that selective PCI was better than immediate PCI in the clinical efficacy and security for STEMI patients with TIMI 3 blood flow.