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Background Coronary slow flow (CSF) during primary percutaneous coronary intervention (PCI) is closely related to the prognosis of patients with acute myocardial infarction (AMI).Whether Enhanced Exteal CounterPulsation (EECP) could improve the phenomenon and enhance cardiac function in these patients has not been studied.Methods Seventy-eight AMI patients undergoing primary PCI were enrolled and divided into 2 groups,EECP group and sham group.In EECP group,the patients were treated with EECP for 30 min after coronary artery stent implantation;and in sham group,the patients after coronary artery stent implantation were treated with cuffs wrapped for 30 min.Hemodynamics and corrected TIMI Frame Count (cTFC) were recorded at different time points in both groups.CRP,HCY,NT-proBNP and Killip class were also detected before operation and after treatment.Results In EECP group,compared to pre-and post-EECP treatment,the systolic blood pressure (SBP) was much lower (P ＜0.05),diastolic blood pressure (DBP) and mean arterial blood pressure (MBP) were much higher (P ＜0.05).The heart rate (HR) was not changed during EECP treatment (P ＞0.05).In sham group,SBP,DBP,MBP and HR were not significantly changed during these period (P ＞0.05).In EECP group,the cTFC of patients with CSF decreased significantly after treatment (P ＜0.05);and there was no difference in sham group (P ＞0.05).Compared with pre-EECP treatment,CRP and HCY were increased in post-EECP treatment of both groups (P ＜0.05),while,they were much lower in EECP group (P ＜0.05).The expression of NT-proBNP was decreased after treatment in both groups (P ＜0.05),and it was much lower in EECP group than in sham group (P ＜0.05).The Killip class was much lower after treatment than before operation in EECP group (P ＜0.05),and there was no change in sham group (P＞0.05).Conclusions The results suggest that EECP is helpful in a short time to the improvement of CSF and recovery of cardiac function in AMI patients during primary PCI,and that CRP and HCY may be involved in this process.