Objective  To observe the clinical efficacy of early application of PCSK-9 inhibitors in treatment of acute ST segment elevation myocardial infarction (STEMI) patients with spontaneous recanalization of culprit vessels.

  Methods  A total of 124 STEMI patients with spontaneous recanalization of culprit vessels after percutaneous coronary intervention (PCI) from January to June 2020 in the Second Affiliated Hospital of Zhengzhou University were selected, they were divided into evolocumab group (n=70) and control group (n=54) according to the use of PCSK-9 inhibitor. The success rate of operation and blood flow classification of thrombolysis in myocardial infarction (TIMI) were compared between the two groups, and echocardiography and cardiac function markers were used to evaluate the recovery of cardiac function. Incidence rates of major adverse cardiovascular events (MACE) and clinical adverse events in 6 months of follow up were recorded.

  Results  The average hospital stay, low density lipoprotein cholesterol, N-terminal pro-brain natriuretic peptide, preoperative and postoperative high-sensitivity C reactive protein levels of the patients in the evolocumab group were significantly lower than those in the control group, while the left ventricular ejection fraction, preoperative and postoperative ratios of grade 3 blood flow of TIMI were significantly higher than those in the control group (P < 0.05). The incidence of MACE within 6 months of follow-up in the evolocumab group was significantly lower than that in the control group (P < 0.05).

  Conclusion  For STEMI patients with spontaneous recanalization of culprit vessels, early application of PCSK-9 inhibitor can increase myocardial reperfusion volume and improve cardiac function and prognosis.