Abstract: Aim: was to evaluate the safety and efficacy of delayed endovascular treatment without stent implantation in ST-elevation myocardial infarction (STEMI) caused by massive thrombotic load and ectasia of infarct-related coronary artery. Material and methods: out of 4263 primary percutaneous coronary interventions (PCI) performed for STEMI for the period from January 2016 to September 2021, retrospective analysis included data of 21 patients with ectasia of infarct-related coronary artery and massive thrombotic load (TTG ? 3). Results: method of delayed endovascular treatment, without stent implantation, in STEMI caused by massive thrombotic load and ectasia of infarct-related coronary artery, allowed to significantly improve parameters of epicardial coronary blood flow according to TIMI and CFTC scales in 71% and 67% of examined patients (p <0,001, p=0,001); increase myocardial perfusion according to MBG in 62% of patients (p=0,001); reduce the severity of thrombotic load according to TTG scale in 71% of the subjects (p=0,001). Conclusion: in patients with ST-elevation myocardial infarction caused by massive thrombotic load and ectasia of infarct-related coronary artery, the strategy of delayed endovascular treatment with-out stent implantation is safe and effective at the hospital stage.
Abstract: Introduction: percutaneous coronary intervention plays an important role in treatment of acute myocardial infarction with ST-segment elevation. However, the benefit of performing delayed PCI is controversial (>12h after onset of symptoms typical for STEMI). Aim: was to compare results of PCI and medical therapy (MT) in patients, who had been admitted to the hospital with verified STEMI, diagnosed 12 hours after the onset of symptoms, and to estimate their effect on clinical outcomes. Material and methods: data of 100 patients was analyzed, PCI was performed in 62 patients and 38 patients underwent medical therapy. The task was to compare clinical outcomes, which included mortality and major adverse cardiac events (MACE). Results: all-cause mortality in groups of delayed PCI and MT was 4 (6,45%) and 9 (23,6%) respectively (p <0,05). It was also recorded that minor cases of cardiac death occurred in the group of delayed PCI in comparison with the MT group, 1 (1,6%) and 6 (15,7%) respectively (p <0,05). Conclusion: delayed PCI (12 hours after the onset of the myocardial infarction in STEMI patients) leads to improvement in all-cause mortality and cardiac death rates compared with conservative treatment.
