EXTENDED INDICATIONS FOR PERCUTANEOUS CORONARY INTERVENTIONS AFTER SUCCESSFUL THROMBOLYSIS

Khubutiya M.Sh., Zakharov I.V., Gazarian G.A., Chepky D.A., Klimovsky S.D.
N.V. Sklifosovsky Research Institute for Emergency Care,
Moscow, Russia

The study compared the efficiency of percutaneous coronary interventions (PCI) into infarctionrelated coronary artery (IRCA) in highrisk patients with acute myocardial infarction (AMI), that were fulfilled 1224 hours since the pain syndrome onset or during recurrent ischemic episodes 3 days after successful thrombolysis. In the first group (68 patients) invasive restoration of blood flow was fulfilled in 3 days (at average 48 hours) after AMI onset due to recurrent ischemia. In the second group (56 patients) IRCA recanalization was fulfilled in 1224 hours (at average 20 hours) since pain syndrome onset due to clinical signs of unfavorable outcome high risk. IRCA recanalization was successful in 91% and 97% of cases in the first and second groups, respectively. In all cases injection of contrast media Ultravist 370 was diagnostically significant and visualized coronary arteries free of adverse events. In control group (conservative treatment) IRCA occlusion or subtotal stenosis was diagnosed in 18% and 39% of cases, respectively; stenosis >75% and <75% – in 27% and 16%, respectively. CONCLUSION: in highrisk patients with AMI percutaneous coronary interventions into IRCA can be effective 1224 hours after successful thrombolytic therapy.

KEY WORDS: percutaneous coronary interventions, thrombolytic therapy, acute myocardial infarction.

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