Abstract
Aim. To study the results of endovascular revascularization in older patients with ST elevation myocardial infarction (STEMI) in multivessel disease (MV). Material and methods. Totally, 327 patients included. Inclusion criteria were: STEMI with duration <12 hours and primary PCI; hemodynamically significant (≥70%) lesion of 2 and more coronary arteries; technically possible percutaneous intervention (PCI). Criteria of exclusion: acute heart failure Killip III-IV (pulmonary edema and cardiogenic shock); left main stem lesion ≥50%. Patients were selected to 2 groups according to their age. To the 1st group we included elderly persons (age ≥65 y., n=103), to the second — patients younger than 64 y.o., n=224. Endpoints of the study were death, myocardial infarction (MI) (fatal and non-fatal), recurred non-scheduled target vessel revascularization, and the prevalence of combination endpoint. Evaluation of long-term results was done with clinical data collection during office visit or phone survey. Results. The group of elderly patients was characterized by expectedly more severe comorbidities, usually having cardiovascular risks as associated diseases, had higher SYNTAX score, significantly higher 30-day and year mortality rates. Prevalence of three-vessel disease, as the usage of drug-coated stents and multivessel strategy (MS) under the primary PCI tactics, were comparable. Conclusion. Sedentary patients were characterized by higher levels of mortality in acute myocardial infarction in hospital period, which makes significant to do more investigations for the development of optimal revascularization strategies in elderly patients having MV.
Highlights
инфаркта миокарда с подъемом сегмента ST (ИМпST) — инфаркт миокарда с подъемом сегмента ST, ИМ — инфаркт миокарда, ТС — тромбоз стента, многососудистом поражении (МП) — многососудистое поражение, чрескожного коронарного вмешательства (ЧКВ) — чрес кожное коронарное вмешательство, многососудистого стентирования (МС) — многососудистое стентирование, ФВ ЛЖ — фракция выброса левого желудочка, ПИКС — постинфарктный кардиосклероз
Примечание: * — смерть от всех причин + нефатальный ИМ + повторная реваскуляризация целевого сосуда
2. Jan MF, Moiz-Hafiz A, Mori N, et al Contemporary Door-to-Balloon Times With Primary Percutaneous Coronary Intervention in Elderly versus Younger Patients Presenting With Acute ST-Segment Elevation Myocardial Infarction
Summary
Aim. To study the results of endovascular revascularization in older patients with ST elevation myocardial infarction (STEMI) in multivessel disease (MV). Что ЧКВ может быть рассмотрено как эффективный инструмент снижения летальности от ИМпST, особенно в группе пожилых больных. Стоит отметить, что в основу для актуальных рекомендаций по оказанию помощи при ИМпST положены данные крупных клинических исследований, в которые, как правило, систематически не включались лица старших возрастных групп [7]. Что эти результаты не могут быть безоговорочно экстраполированы на категорию больных пожилого возраста и делает актуальным анализ результатов ЧКВ у пожилых больных в условиях реальной клинической практ ики. Целью настоящего исследования явилось изучение результатов эндоваскулярной реваскуляризации у пожилых больных ИМпST при многососудистом поражении (МП) коронарного русла.
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