Влияние чрескожного коронарного вмешательства на госпитальную летальность и клиническое течение острого инфаркта миокарда с подъемом сегмента ST с вовлечением и без вовлечения правого желудочка

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Abstract

The aim of the present study was to assess the efficacy of percutaneous coronary intervention (PCI) in patients with ST elevated myocardial infarction (STEMI) with evidence of right ventricular (RV) involvement. The main outcome was in-hospital mortality, and secondary outcomes were heart failure, atrioventricular blocks II-III d., ventricular arrhythmias, and severe mitral regurgitation. The present study was a retrospective observational study. Totally we enrolled 535 patients with STEMI. RV involvement was diagnosed in 179 patients. Patients having received fibrinolytic therapy were excluded from the study. In the group of patients with RV involvement cases of heart failure, atrioventricular blocks II-III, and severe mitral regurgitation were significantly more common in comparison with no RV involvement group. RV involvement in no PCI patients was associated with an increased in-hospital mortality (RVI: 35.4% vs. no RVI: 21.6%; p=0.02). PCI was associated with the reduced in-hospital mortality (PCI: 8.2% vs. no PCI: 32.4%; p=0.00001), severe mitral regurgitation, and heart failure in RV involvement group. There is no significant difference in PCI patients mortality between groups with and without RV involvement (RVI: 8.2% vs. no RVI: 6.3%; p=0.6). Conclusion: a strategy of PCI results in a significant reduction in in-hospital mortality and morbidity in STEMI patients with RV involvement.

References

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Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, Director of Bakoulev National Medical Research Center for Cardiovascular Surgery