To investigate the efficacy and safety of intravenous Esmolol in patients with acute st-elevation myocardial infarction (STEMI) during PCI.

  AIM  To investigate the efficacy and safety of intravenous Esmolol in patients with acute st-elevation myocardial infarction (STEMI) during PCI.

  METHODS  A total of 117 STEMI patients were enrolled and divided into Esmolol group (n = 59) and placebo group (n = 58). The primary outcome was the laboratory results of troponin T 24 hours after PCI. The secondary observation end point was the change of ST on ECG at 90 min after PCI, and the echocardiography was reexamined at 3 days, 6 weeks, 12 weeks and 24 weeks after the operation. The Seattle SAQ scale and the major adverse cardiovascular events (MACE) was collected at 24 weeks out of hospital.

  RESULTS  There were no significant differences in general situation, risk factors, clinical medication and other treatment conditions between the two groups (P > 0.05). cTnI (ng/ml) (13.707.74-33.80 vs. 26.05 10.70-57.90, P = 0.028) and CK-MB (ng/ml) 8.22 (4.07,23.50) vs. 22.95 (4.00,57.63), P < 0.05) showed significant differences. Additionally, we observed that intravenous Esmolol significantly improved the ejection fraction of left ventricle of Esmolol group (LVEF) 57 (52, 65) vs. 53(48,57), P < 0.01) at 24 weeks after the operation. There was also significant difference about the ST segment decrease of 50% (P < 0.01) at 90 min after the operation.

  CONCLUSION  intravenous Esmolol during PCI can reduce myocardial injury, improve myocardial ischemia and left ventricular ejection fraction in patients with acute st-elevation myocardial infarction (STEMI).