[Percutaneous revascularization of myocardium: extent, application and treatment strategy of acute coronary syndromes]. / Perkutanine miokardo revaskulizacija ligoniams, sergantiems uminiais koronariniais sindromais. Gydymo apimtys ir strategija.

ABSTRACT

UNLABELLED The comparative value of different factors of reperfusion technique and strategy in restoring of myocardial function is underestimated. The aim of this study is to assess the value of reperfusion strategy for restoring of myocardial function in follow-up period. MATERIAL AND METHODS: From 1999 to 2001, 4260 patients with acute coronary syndromes were analyzed. Coronarography was performed for 2990 patients and percutaneous coronary interventions - for 1257 patients. QRS score was calculated; electrocardiogram and echocardiograms were done for 248 patients with acute myocardial infarction after reperfusion therapy by percutaneous transluminal coronary angioplasty (PTCA) (228 patients) and by stenting (20 patients). Urgent PTCA was used for 114 patients, urgent stenting for 14 patients, delayed PTCA for 114 patients and delayed stenting for 6 patients. RESULTS: Coronarography was performed for 66% of all hospitalized patients; percutaneous coronary interventions - for 825 (45.6%) of patients with acute myocardial infarction and only for 11.7% of patients with unstable angina pectoris. In hospital period QRS score increased for all patients with the exception of patients with delayed stenting (p from 0.05 to 0.001). LVEF had tendency to increase in all groups of patients during 3 months. CONCLUSIONS: Coronarography can be performed for 65-70% of hospitalized patients with acute coronary syndromes and percutaneous coronary interventions for 45% of patients with acute myocardial infarction. Differences in reperfusion strategy do not have manifest value on restoring of left ventricle function.