Efficacy of pharmacoinvasive strategy in patients with ST-segment elevation acute coronary syndrome

Authors: R.Yu. Reztsov, D.V. Skrypnik, E.V. Konovalova, O.V. Makarycheva, E.Yu. Vasilieva, A.V. Shpektor

Company: A.I. Evdokimov Moscow State University of Medicine and Dentistry, Ministry of Health of the RF

For citation: Reztsov R.Yu., Skrypnik D.V., Konovalova E.V., Makarycheva O.V., Vasilieva E.Yu., Shpektor A.V. Efficacy of pharmacoinvasive strategy in patients with ST-segment elevation acute coronary syndrome. Kreativnaya kardiologiya. 2014; 2: 14-19.

Keywords: myocardial infarction reperfusion acute coronary syndrome

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Purpose. The aim of this study was to evaluate efficacy of pharmacoinvasive strategy.

Material and methods.
682 patients with ST-segment elevation acute myocardial infarction admitted to the City Hospital #23 in 2006–2011 were included retrospectively. Primary percutaneous coronary intervention (PCI) was performed in 182 patients (group I), 174 patients were managed with thrombolysis followed by PCI in 3–72 hours (group II). In group III we included 326 patients, in whom only thrombolysis was carried out. There was no significant difference in mortality between groups.

However we found tendency towards mortality rate reduction in patients with pharmacoinvasive therapy. In 48 hours of admission to the hospital mortality rate did not differ significantly in all groups. Within 48 hours admission mortality depended on chosen treatment strategy. In patients with pharmacoinvasive approach 48 hours mortality was significantly lower, than in patients with thrombolysis (3.30 vs 6.74%, respectively). In pharmacoinvasive group tendency towards mortality rate reduction comparing to PCI group was also revealed (2.30 vs 3.30%, respectively).

Retrospective analysis of pharmacoinvasive strategy results shows that mortality rate will be reduced since not all patients after thrombolysis will survive till PCI. Actual 48-hour mortality rate in patients with pharmacoinvasive approach varies between 2.87–6.89% and depends on time of PCI performance after thrombolysis.


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Chief Editor

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