The comparison of revalcularization outcomes in acute coronary syndrom following primary coronary angioplasty

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Abstract

Purpose. To compare clinical and morphofunctional outcomes of revascularization in patients after primary coronary angioplasty with different degree of coronary arteries damage and type of myocardial infarction.

Material and methods. The research involved 258 patients after myocardial infarction who underwent coronary balloon angioplasty with stenting infarct-related artery. By electrocardiographic and angiographic picture all patients were divided into 4 groups: Q-wave myocardial infarction and without Q-wave myocardial infarction with single-vessel and multivessel disease.

Results. The study found that the patients with non Q-wave myocardial infarction and single-vessel disease had no adverse clinical outcomes during a year. The wall motion index and the ejection fraction almost recovered completely (wall motion index varied from 1.18 ± 0.02 to 1.05 ± 0.02 and ejection fraction — from 57.4 ± 0.5% to 63.3 ± 0.6%; р < 0.001). All the patients with Q-wave myocardial infarction revealed similar clinical outcomes and morphofunctional characteristics. The group of patients with non Q-wave and multivessel disease had the highest rate of adverse clinical outcomes with progressing left-ventricular disfunction according to echocardiography (wall motion index varied from 1.15 ± 0.01 to 1.19 ± 0.04 and ejection fraction — from 53.9 ± 0.5% to 55.1 ± 0.6%; р < 0.001).

Conclusion. The degree of coronary arteries damage in the patients with Q myocardial infarction did not influence postinfarction remodeling and long-term cardiac outcomes. The patients with non-Q myocardial infarction and single-vessel disease had fewer signs of postinfarction remodeling and complications in postinfarction period. The worst prognosis was revealed by patients with similar forms of myocardial infarction and multivessel disease.

About the authors

Olga V. Abramova

North-Western State Medical University named after I.I. Mechnikov

Author for correspondence.
Email: abramova.olja@mail.ru

Head of ICU of patients with myocardial infarction
Russian Federation, Saint Petersburg

Sergey A. Saiganov

North-Western State Medical University named after I.I. Mechnikov

Email: Sergey.Saiganov@szgmu.ru

Professor, head of the Department of Hospital Therapy and Cardiology named after M.S. Kushakovsky
Russian Federation, Saint Petersburg

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2. Fig. 1. Dynamics of wall motion score index in groups 1 and 2

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3. Fig. 2. Dynamics of wall motion score index in groups 3 and 4

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4. Fig. 3. The dynamics of the end-diastolic volume of the left ventricle in groups 3 and 4

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Copyright (c) 2020 Abramova O.V., Saiganov S.A.

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