Criteria of appropriate incomplete revascularization in patients with ST-segment elevation myocardial infarction in multivessel lesion of the coronary bed

Tarasov R.S.

Scientific Research Institute of Complex Problems of Cardiovascular Diseases, Kemerovo, Russia

The study was aimed at analysing the outcomes of multivessel revascularization by means of percutaneous coronary intervention (PCI) in a total of 190 patients presenting with ST segment elevation myocardial infarction (STEMI) and multivessel lesion (MVL) of coronary arteries. Patients with unsuccessful PCI or those having received no planned second stage of revascularization for any reason were excluded from the study. The patients were subdivided into two groups: Group One comprised those having received appropriate complete revascularization (CR) within the framework of multivessel stenting (MVS) during primary PCI or a stagewise approach (n=137), Group Two included patients with the so-called appropriate incomplete revascularization (AIR) after MVS or stagewise PCI (n=53). In all cases IR was considered appropriate due to the presence of the corresponding anatomical and/or functional criteria used in the literature but not studied in relation to the cohort of patients with STEMI: (1) small arterial diameter (<2.5 mm), (2) not more than one epicardial vessel left without revascularization, (3) stenoses in second-order branches in a minimally symptomatic course of the disease, (4) nonviable myocardium or small volume of the viable myocardium in the area of blood supply of the artery. The carried out analysis of the incidence rate of adverse cardiovascular events during 12 months of follow up showed no significant differences between the studied groups. A conclusion was made that criteria of AIR may effectively be implemented also in the cohort of patients with STEMI, which would promote optimization of therapeutic results in such patients, decreasing the risk of complications associated with unsubstantiated PCI.

KEY WORDS: myocardial infarction, primary percutaneous coronary intervention, multivessel lesion, complete revascularization, incomplete appropriate revascularization.

P. 132

« Back