PECULIARITIES OF THE HOSPITAL STAGE OF ACUTE MYOCARDIAL INFARCTION IN PATIENTS WITH VARYING SEVERITY OF CORONARY ATHEROSCLEROSIS ON A SCALE SYNTAX AFTER ENDOVASCULAR TREATMENT
I.A. Urvantseva1, K.Yu. Nikolaev2, A.A. Nikolaeva2, E.V. Milovanova1, A.A. Seitov1, G.I. Lifshits2,3
1Budget Institution of Khmao-Yugra County Cardiology Clinic В«Centre for Diagnostics and Cardiovascular Surgery», 628400, Surgut, Lenin str., 69/1
2Research Institute of Internal and Preventive Medicine, 630089, Novosibirsk, Boris Bogatkov str., 175/1
3Institute of Chemical Biology and Fundamental Medicine of SB RAS, 630090, Novosibirsk, Academic Lavrentiev av., 8
Keywords: acute myocardial infarction with ST-segment elevation, coronary lesions on a scale SYNTAX, complications of the myocardial infarction
Abstract
The aim of this study was to investigate characteristics of a hospital phase of acute myocardial infarction in patients with varying degrees of severity of coronary lesions on a scale SYNTAX after endovascular treatment. The severity of coronary lesions on a scale SYNTAX evaluated in 330 consecutive patients (274 men and 56 women), mean age 53.6 ± 8.9 years, with acute myocardial infarction with ST-segment elevation. This patients were divided into three groups: a group with severe coronary disease (SYNTAX ≥ 33), with moderate (SYNTAX from 23 to 32) and low lesion (SYNTAX from 0 to 22). In patients with severe coronary disease had fewer than in patients with low values of the defeat of the Mean Corpuscular Hemoglobin (MCH), Mean Corpuscular Hemoglobin Concentration (MCHC), and total protein, and high density lipoprotein cholesterol. In groups with SYNTAX from 23 to 32 and with SYNTAX ≥ 33 higher blood glucose levels than in the SYNTAX from 0 to 22, and the rate of urea in patients with severe coronary disease exceed the value of this parameter in patients with low and moderate coronary disease. In patients with severe coronary disease are more likely than those with low lesions observed the phenomenon of non-resumption of blood flow after stenting (no-reflow), stent thrombosis, pulmonary edema, acute aneurysm recurrence of heart attack and bleeding. Using binary logistic regression (χ
2 model = 25.4, p < 0.001) we revealed that with heavy coronary lesion (SYNTAX ≥ 33) most significantly associated pleural effusion ( p < 0.001), the phenomenon of non-renewal blood flow after stenting (no-reflow) ( p = 0.004), and acute aneurysm ( p = 0.039).
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