THE RESULTS OF A VARIETY OF STRATEGIES APPLICATION IN PRIMARY PERCUTANEOUS INTERVENTION IN ST ELEVATION MYOCARDIAL INFARCTION PATIENTS AND MULTIVESSEL DISEASE ACCORDING TO THE GRADE OF LESION SEVERITY BY SYNTAX SCORE
https://doi.org/10.15829/1728-8800-2015-2-19-24
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Abstract
Aim. To study the results of various revascularization strategies in ST elevation myocardial infarction patients (STEMI) and multivessel disease (MD) according to the severity of coronary lesion by SYNTAX score. Material and methods. Totally 327 patients included with STEMI and MD, undergoing primary percutaneous intervention (PCI). Patients were distributed into 2 groups: (1) multivessel disease and stenting (MS) in PCI (n=91); (2) staged revascularization (SR) (n=236); Each group was then divided into 2 subgroups according to the severity of coronary lesion by SYNTAX (SYNergy between PCI with TAXUS and cardiac surgery): SYNTAX <22 points и SYNTAX >23 points. The endpoints were significant adverse cardiovascular events (ACE). Results. During 12 months of follow-up the worse results are shown in revascularization of patients with the SYNTAX severity >23 points, reached statistically significant differences in groups of patients as with staged revascularization, as the cohort of patients selected for MS.
Conclusion. The SYNTAX score can be successfully applied not only for patients with stable ischemic heart disease, but in STEMI too. It is shown that the highest risk of ACE development during one year after primary PCI is in the patients with SYNTAX >23 who undergo staged PCI.
About the Authors
R. S. Tarasov
FSBI "Scientific-Research Institute of Complex Cardiovascular Diseases of SD RAMS". Kemerovo, Russia
Russian Federation
Russian Federation
V. I. Ganyukov
FSBI "Scientific-Research Institute of Complex Cardiovascular Diseases of SD RAMS". Kemerovo, Russia
Russian Federation
Russian Federation
O. L. Barbarash
FSBI "Scientific-Research Institute of Complex Cardiovascular Diseases of SD RAMS". Kemerovo, Russia
Russian Federation
Russian Federation
L. S. Barbarash
FSBI "Scientific-Research Institute of Complex Cardiovascular Diseases of SD RAMS". Kemerovo, Russia
Russian Federation
Russian Federation
References
1. Dambrink JHE, Debrauwere JP, van't Hof AWJ. Non-culprit lesions detected during primary PCI: treat invasively or follow the guidelines? Eurointervention 2010; 5: 968-75.
2. Cardarelli F, Bellasi A, Fang-Shu Ou, et al. Combined impact of age and estimated glomerular filtration rate on in-hospital mortality after percutaneous coronary intervention for acute myocardial infarction (from the American College of Cardiology National Cardiovascular Data Registry). Am J Cardiol 2009; 103: 766-71.
3. Addala S, Grines CL, Dixon SR, et al. Predicting mortality in patients with ST-elevation myocardial infarction treated with primary percutaneous coronary intervention (PAMI risk score). Am J Cardiol 2004; 93: 629-32.
4. Halkin A, Singh M, Nikolsky E, et al. Prediction of mortality after primary percutaneous coronary intervention for acute myocardial infarction: the CADILLAC risk score. JACC 2005; 45: 1397-405.
5. Morrow DA, Antman EM, Charlesworth A, et al. TIMI risk score for ST-elevation myocardial infarction: a convenient, bedside, clinical score for risk assessment at presentation: an intravenous nPA for treatment of infarcting myocardium early II trial substudy. Circulation 2000; 102: 2031-7.
6. Eagle KA, Lim MJ, Dabbous OH. GRACE Investigators et al. A validated prediction model for all forms of acute coronary syndrome: estimating the risk of 6-month postdischarge death in an international registry. JAMA 2004; 291: 2727-33.
7. De Luca G, Suryapranata H, van't Hof AW, et al. Prognostic assessment of patients with acute myocardial infarction treated with primary angioplasty: implications for early discharge. Circulation 2004; 109: 2737-43.
8. Serruys PW, Morice MC, Kappetein AP, et al. Percutaneous Coronary Intervention versus Coronary-Artery Bypass Grafting for Severe Coronary Artery Disease. The New England J Med 2009; 360(10): 961-72.
9. Serruys PW, Onuma Y Garg S, et al. Assessment of the SYNTAX score in the SYNTAX study. EuroIntervention 2009; 5: 50-6.
10. Garg S, Sarno G, Serruys PW, et al. Prediction of 1-Year Clinical Outcomes Using the SYNTAX Score in Patients With Acute ST-Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention. JACC 2011; 4(1): 66-75.
11. Yang CH, Hsieh MJ, Chen CC, et al. SYNTAX score: an independent predictor of long-term cardiac mortality in patients with acute ST-elevation myocardial infarction. Coron Artery Dis 2012; 23(7): 445-9.
12. Tarasov RS, Ganyukov VI, Shushpannikov PA, et al. SYNTAX score estimates of coronary stenosis severity and outcomes of various revascularization strategies in patients with ST segment elevation myocardial infarction and multi-vessel coronary pathology. Russian Journal of Cardiology 2013; 2(100): 31-7. Russian (Tarasov R. S., Ganyukov V.I., Shushpannikov P. A. i dr. Iskhody razlichnykh strategii revaskulyarizatsii u bol'nykh infarktom miokarda s elevatsiei segmenta ST pri mnogososudistom porazhenii v zavisimosti ot tyazhesti stenozirovaniya koro¬narnogo rusla po shkale "SYNTAX". Rossiiskii kardiologicheskii zhurnal 2013; 2(100): 31-7).
13. Tarasov RS, Ganyukov VI, Shushpannikov PA, et al. Optimal timing of the second stage of revascularization in the treatment of patients with ST-segment elevation myocardial infarction with multivessel disease. Cardiologiia 2013; 7: 9-12. Russian (Tarasov R. S., Ganyukov V. I., Shushpannikov P. A. i dr. Optimal'nye sroki vypolneniya vtorogo etapa revaskulyarizatsii v lechenii patsientov s infarktom miokarda i elevatsiei segmenta ST pri mnogososudistom porazhenii. Kardiologiya 2013; 7: 9-12).
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For citations:
Tarasov R.S., Ganyukov V.I., Barbarash O.L., Barbarash L.S. THE RESULTS OF A VARIETY OF STRATEGIES APPLICATION IN PRIMARY PERCUTANEOUS INTERVENTION IN ST ELEVATION MYOCARDIAL INFARCTION PATIENTS AND MULTIVESSEL DISEASE ACCORDING TO THE GRADE OF LESION SEVERITY BY SYNTAX SCORE. Cardiovascular Therapy and Prevention. 2015;14(2):19-24. (In Russ.) https://doi.org/10.15829/1728-8800-2015-2-19-24
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ISSN 1728-8800 (Print)
ISSN 2619-0125 (Online)
ISSN 2619-0125 (Online)
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