Abstract：Objective To observe the clinical application effect of early intravenous heparinization in elderly patients with acute ST-segment elevation myocardial infarction (STEMI). Methods A total of 100 patients diagnosed with acute STEMI who were admitted to Yuedong Hospital, the Third Affiliated Hospital of Sun Yat-sen University from January 2019 to May 2020 were selected as the research objects. All patients planned to undergo coronary angiography and percutaneous coronary intervention (PCI). The patients were divided into the control group and the experimental group by random drawing, with 50 cases in each group. The experimental group was treated with unfractionated Heparin,while the control group was not given Heparin before operation. The coronary angiography, the peak time of serum myocardial markers such as troponin I (cTnI) and creatine kinase isoenzyme (CK-MB), hospitalization time, major cardiovascular and bleeding events occurring within 30 days outside the hospital were compared between the two groups. Results The thrombus aspiration rate (28.00%) of the experimental group was lower than that of the control group(48.00%), while the thrombolysis rate (40.00%) was higher than that of the control group (12.00%), the use rate of Tirofiban (28.00%) was lower than that of the control group (72.00%), the incidence of no-reflow (0.00%) was lower than that of the control group (12.00%), proportion of TIMI grade 3 blood flow (62.00%) was higher than that of control group (40.00%), the differences were statistically significant (P＜0.05). The peak time of cTnI and CK-MB serum myocardial markers and hospitalization time in the experimental group were shorter than those in the control group, the differences were statistically significant (P＜0.05). The incidence rate of bleeding in the experimental group (0.00%) was lower than that in the control group (10.00%), while the ST segment resolution rate (76.00%) was higher than that in the control group (54.00%), the differences were statistically significant (P＜0.05). Conclusion In the elderly patients with acute STEMI, early intravenous heparinization therapy can significantly improve the situation of coronary angiography.
Ibanez B，James S，Agewall S，et al.2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation：The Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology （ESC）[J].Eur Heart J，2018，39（2）：119-177.
Vora AN，Holmes DN，Rokos I，et al.Fibrinolysis use among patients requiring interhospital transfer for ST-segment elevation myocardial infarction care：a report from the US National Cardiovascular Data Registry[J].JAMA Intern Med，2015，175（2）：207-215.
Pu J，Ding S，Ge H，et al.Efficacy and Safety of a Pharmaco-Invasive Strategy With Half-Dose Alteplase Versus Primary Angioplasty in ST-Segment-Elevation Myocardial Infarction：EARLY-MYO Trial （Early Routine Catheterization After Alteplase Fibrinolysis Versus Primary PCI in Acute ST-Segment-Elevation Myocardial Infarction）[J].Circulation，2017，136（16）：1462-1473.
Shen C，Wang LF.Effect of thrombus aspiration during primary percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction[J].Chin J Cardiol，2019，47（1）：49-55.
[13]
Hashimoto T，Ako J，Nakao K，et al.Pre-procedural thrombolysis in myocardial infarction flow in patients with STsegment elevation myocardial infarction[J].Int Heart J，2018，59（5）：920-925.
[14]
Chacón-Diaz M，Araoz-Tarco O，Alarco-León W，et al.Heart failure complicating myocardial infarction.A report of the Peruvian Registry of ST-elevation myocardial infarction（PERSTEMI）[J].Arch Cardiol Mex，2018，88（5）：447-453.
[15]
Louis DW，Kennedy K，Lima FV，et al.Association between maximal activated clotting time and major bleeding complications during transradial and transfemoral percutaneous coronary intervention[J].JACC Cardiovasc Interv，2018，11（11）：1036-1045.
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