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Journal

2009 | 4 | 3 | 265-271

Article title

The meaning of early percutaneous coronary intervention in acute coronary syndrome with preserved ST elevation

Content

Title variants

Languages of publication

EN

Abstracts

EN
To determine if delaying the primary precutaneous coronary intervention (PCI) for >6 hours for acute coronary syndrome with preserved ST elevation (STE-ACS) affects the PCI angiography effectiveness and clinical prognosis. The PCI was performed: for 71% of patients <6h (group 1), for 29% of patients >6h from the beginning of pain (group 2). For 1% of patients from group 1 and 3.4% of patients from group 2, no passage has been opened in the artery after STE-ACS. In spite of opening the passage mechanically, the phenomenon of lack of tissue reflow occurred in 2.7% of patients from group 1 and 12% of patients from group 2. Dangerous ventricular arrhythmias occurred more frequently in patients from group 2, including VF, asystole, haemodynamic complications classed 4° according to the Killip-Kimball scale and death. In an univariate logistic regression analysis, the following risk factors for death during the hospital phase were identified: delayed PCI >6 hours, 4° haemodynamic complications according to the Killip-Kimball scale, LVEF <40%, FV, p-k III block, TIMI <3, and no-reflow. In a multivariate logistic regression analysis, 4° according to the Killip-Kimball scale turned out to be the only risk factor for death during the hospital phase. Delaying PCI during STE-ACS for >6 hours significantly lowers the statistical chance to recover both full permeability and effective tissue reflow in the artery responsible for STE-ACS, which is connected with a significantly higher risk of serious complications, as well as with 8.5% risk of death during the hospital phase. The most significant, independent factor determining the survival of patients with STE-ACS after PCI is lack of cardiogenic shock.

Publisher

Journal

Year

Volume

4

Issue

3

Pages

265-271

Physical description

Dates

published
1 - 9 - 2009
online
3 - 7 - 2009

Contributors

  • Cardiology Clinic, I Cardiology and Cardio-Surgery Department, Medical University, 91-425, Łódź, Poland
  • Cardiology Clinic, I Cardiology and Cardio-Surgery Department, Medical University, 91-425, Łódź, Poland
  • Institute of Molecular Cardionephrology and Hypertensio Arterialis, Medical University, 90-549, Łódź, Poland
author
  • Cardiology Clinic, I Cardiology and Cardio-Surgery Department, Medical University, 91-425, Łódź, Poland

References

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Document Type

Publication order reference

Identifiers

YADDA identifier

bwmeta1.element.-psjd-doi-10_2478_s11536-009-0042-5
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