The meaning of early percutaneous coronary intervention in acute coronary syndrome with preserved ST elevation
| Autor: | Jan Henryk Goch, Magdalena Wierzbicka, Maciej Kośmider, Agata Bielecka-Dąbrowa |
|---|---|
| Rok vydání: | 2009 |
| Předmět: |
medicine.medical_specialty
Acute coronary syndrome Ejection fraction medicine.diagnostic_test time to treatment business.industry Cardiogenic shock medicine.medical_treatment ST elevation percutaneous coronary intervention cardiogenic shock Percutaneous coronary intervention General Medicine medicine.disease Internal medicine Angiography Conventional PCI medicine Cardiology Medicine cardiovascular diseases Asystole business |
| Zdroj: | Open Medicine, Vol 4, Iss 3, Pp 265-271 (2009) |
| ISSN: | 2391-5463 |
| DOI: | 10.2478/s11536-009-0042-5 |
| Popis: | To determine if delaying the primary precutaneous coronary intervention (PCI) for >6 hours for acute coronary syndrome with preserved ST elevation (STE-ACS) affects the PCI angiography effectiveness and clinical prognosis. The PCI was performed: for 71% of patients 6h from the beginning of pain (group 2). For 1% of patients from group 1 and 3.4% of patients from group 2, no passage has been opened in the artery after STE-ACS. In spite of opening the passage mechanically, the phenomenon of lack of tissue reflow occurred in 2.7% of patients from group 1 and 12% of patients from group 2. Dangerous ventricular arrhythmias occurred more frequently in patients from group 2, including VF, asystole, haemodynamic complications classed 4° according to the Killip-Kimball scale and death. In an univariate logistic regression analysis, the following risk factors for death during the hospital phase were identified: delayed PCI >6 hours, 4° haemodynamic complications according to the Killip-Kimball scale, LVEF 6 hours significantly lowers the statistical chance to recover both full permeability and effective tissue reflow in the artery responsible for STE-ACS, which is connected with a significantly higher risk of serious complications, as well as with 8.5% risk of death during the hospital phase. The most significant, independent factor determining the survival of patients with STE-ACS after PCI is lack of cardiogenic shock. |
| Databáze: | OpenAIRE |
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