Protective effect of combined use of standard drug therapy and spironolactone against arrhythmia and heart failure in patients with acute ST-segment elevated myocardial infarction after emergency percutaneous coronary intervention

Abstract

Purpose: To determine the mitigating impact of standardized drug therapy in combination with spironolactone on arrhythmia and heart failure in subjects with severe ST-segment elevation myocardial infarction (STEMI) following exigency percutaneous coronary intervention (PCI). Methods: 120 severe STEMI subjects who underwent exigency PCI were assigned to control and study groups, with 60 patients in each group. Control group received long-term aspirin therapy (85 mg/day, orally) after emergency PCI, while study group received long-term spironolactone therapy (50 mg/day, orally) plus control cohort drug regimen. Treatment effectiveness, heart function, quality of life, electrolyte levels (K+ and Mg2+), and incidence of cardiac adverse events were determined before and post-treatment. Results: Treatment efficacy was markedly greater in study cohort. Post-treatment values of LVEF indicators in both groups were significantly greater than the pre-treatment levels, with markedly higher study cohort levels. In contrast, values of LVEDD and LVESD indicators were significantly reduced in both groups after treatment, but the levels in study group were significantly lower (p < 0.05). Scores on indices of physical function, psychological function, social function, and physical quality of life in both groups were significantly increased after treatment, with significantly higher scores in study cohort (p < 0.05). Post-therapy serum concentrations of K+ and Mg2+ were markedly raised in both groups but with higher levels in study cohort. Incidents of unwanted heart situations were lower in study cohort. Conclusion: Combined use of standard drugs and spironolactone for the treatment of severe STEM1 subjects following emergency PCI is effective. More studies are required to elaborate the mechanistic characteristics of this combination.