Features of percutaneous therapy in non-ST-segment elevation myocardial infarction patients who were admitted to hospital at different times since the onset of symptoms
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Abstract
The aim – to evaluate the effect of coronary revascularization (coronary stenting, CS) on the survival of non-ST-segment elevation myocardial infarction (NSTEMI) patients during interventions at different times since the onset of the disease.
Materials and methods. The study involved 101 patients with NSTEMI. 29 patients were examined urgently (from 0 to 72 h since the onset of the disease). The remaining 72 patients were hospitalized as scheduled and NSTEMI diagnosis was made between 4 and 180 days before coronary ventriculography or CS.
Results and discussion. Patients after CS better tolerated physical activity, they less frequently experienced relapse of angina pectoris and myocardial infarction in comparison with the control group, in which revascularization was not performed. The overall survival of patients with NSTEMI over the 48-month observation period was statistically significantly (p<0.0048) higher in patients who underwent CS than in the control group: 95 % and 80 %, respectively. The cumulative survival without MACE of urgent and planned patients significantly (р=0.002) increased during 48 months of observation in patients who underwent CS and amounted to 78 % compared to 50 % in the control group. Also in the period from 4 to 180 days, the cumulative survival without MACE of NSTEMI patients who underwent SC in a planned manner was significantly higher compared with the control group (p<0.0036): 81 % and 50 %, respectively. In patients after percutaneous interventions, the function of the left ventricle significantly increased and after 48 months of follow-up, the number of patients without disturbances of segmental contractility increased from 82.4 % to 92.4 %. Patients with NSTEMI, who were first diagnosed with dysglycaemia (without diagnosed diabetes mellitus), were more likely to have severe multivessel coronary disease compared with patients who had normal carbohydrate metabolism.
Conclusions. Carrying out CS in NSTEMI patients at different times since the onset of the disease statistically significantly increased both overall and cumulative survival of patients. At the same time, the positive effect of CS on cumulative survival without MACE was noted not only in the group of urgent patients, but also in patients who underwent NSTEMI in the period from 4 to 180 days before hospitalization.
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References
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