LONG-TERM OUTCOMES IN PATIENTS WITH ST-SEGMENT ELEVATION ACUTE CORONARY SYNDROME IN THE APPLICATION OF A PHARMACOINVASIVE APPROACH AND PRIMARY PERCUTANEOUS CORONARY INTERVENTION: RESULTS OF A TWO-YEAR FOLLOW-UP IN REAL CLINICAL PRACTICE CONDITIONS
https://doi.org/10.17650/1818-8338-2015-9-4-22-27
Abstract
Objective: to assess and compare outcomes in patients with ST-segment elevation acute coronary syndrome (STEACS) during 28 months of follow-up in relation to reperfusion therapy policy.
Materials and methods. The investigation was based on the hospital registry of patients with acute coronary syndrome. This investigation enrolled 259 patients with STEACS hospitalized through the emergency medical care channel from January 1, 2012 to January 1, 2013. The safety and efficiency of a pharmacoinvasive (PI) approach (n = 60) and primary percutaneous coronary intervention (PCI) (n = 91) were comparatively analyzed after 28 months of follow-up.
Results. The choice of a reperfusion therapy option (primary PCI or PI approach) failed to affect survival in the patients during 28 months of follow-up. The prediction of cardiovascular mortality and morbidity did not differ in both groups in the study period.
Conclusion. The application of the PI approach to treating patients with STEACS was comparable in its efficiency and impact on long-term outcome as compared to primary PCI in real Russian practice conditions.
About the Authors
A. S. Shilova
I.M. Sechenov First Moscow State Medical University at the Ministry of Health of Russia
Russian Federation
Russian Federation
Department of Preventive and Emergency Cardiology,
Build. 2, 8 Trubetskaya St., Moscow, 119991
N. A. Novikova
I.M. Sechenov First Moscow State Medical University at the Ministry of Health of Russia
Russian Federation
Russian Federation
Department of Preventive and Emergency Cardiology,
Build. 2, 8 Trubetskaya St., Moscow, 119991
D. Yu. Shchekochikhin
I.M. Sechenov First Moscow State Medical University at the Ministry of Health of Russia
Russian Federation
Russian Federation
Department of Preventive and Emergency Cardiology,
Build. 2, 8 Trubetskaya St., Moscow, 119991
A. L. Syrkin
I.M. Sechenov First Moscow State Medical University at the Ministry of Health of Russia
Russian Federation
Russian Federation
Department of Preventive and Emergency Cardiology,
Build. 2, 8 Trubetskaya St., Moscow, 119991
References
1. Task Force on the management of ST-segment elevation acute myocardial infarction of the European Society os Cardiology (ESC), Steg P.G., James S.K. et al. ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation. Eur Heart J 2012;33(20):2569–619.
2. American College of Emergency Phisicians, Society for Cardiovascular Angiography and Interventions, O’Gara P.T. 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: executive summary: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 2013;61(4):485–510.
3. Nallamothu B., Fox K.A., Kennelly B.M. et al. Relationship of treatment delays and mortality in patients undergoing fibrinolysis and primary percutaneous coronary intervention. The Global Registry of Acute Coronary Events. Heart 2007;93(12):1552–5.
4. Terkelsen C.J., Sørensen J.T., Maeng M. et al. System delay and mortality among patients with STEMI treated with primary percutaneous coronary intervention. JAMA 2010;304(7):763–71.
5. Шилова А.С., Новикова Н.А., Сыркин А.Л. Сравнение внутрибольничных исходов у пациентов с острым коронарным синдромом с подъемом сегмента ST при использовании первичного чрескожного вмешательства и фармако-инвазивного подхода. Кардиология и сердечно-сосудистая хирургия 2015;8(5):31–7. [Shilovа А.S., Novikovа N.А., Syrkin А.L. Сomparison of in-patient outcomes at patients with the acute coronary syndrome with the ST-segment elevation, using the primary intracutaneous interference and the pharmaco-invasive approach. Kardiologiya i serdechno-sosudistaya khirurgiya = Cardiology and Cardiovascular Surgery 2015;8(5):31–7. (In Russ.)].
6. Armstrong P.W., Gershlick A., Goldstein P. et al. The Strategic Reperfusion Early After Myocardial Infarction (STREAM) study. Am Heart J 2010;160(1):30–5.e1.
7. Sinnaeve P.R., Armstrong P.W., Gershlick A.H. et al. ST-segment-elevation myocardial infarction patients randomized to a pharmaco-invasive strategy or primary percutaneous coronary intervention: Strategic Reperfusion Early After Myocardial Infarction (STREAM) 1-year mortality follow-up. Circulation 2014;130(14):1139–45.
8. Westerhout C.M., Bonnefoy E., Welsh R.C. et al. The influence of time from symptom onset and reperfusion strategy on 1-year survival in ST-elevation myocardial infarction: а pooled analysis of an early fibrinolytic strategy versus primary percutaneous coronary intervention from CAPTIM and WEST. Am Heart J 2011;161(2):283–90.
9. Danchin N., Coste P., Ferrières J. et al. Comparison of thrombolysis followed by broad use of percutaneous coronary intervention with primary percutaneous coronary intervention for ST-segment-elevation acute myocardial infarction: data from the french registry on acute ST-elevation myocardial infarction (FAST-MI). Circulation 2008;118(3):268–76.
Review
For citations:
Shilova A.S., Novikova N.A., Shchekochikhin D.Yu., Syrkin A.L. LONG-TERM OUTCOMES IN PATIENTS WITH ST-SEGMENT ELEVATION ACUTE CORONARY SYNDROME IN THE APPLICATION OF A PHARMACOINVASIVE APPROACH AND PRIMARY PERCUTANEOUS CORONARY INTERVENTION: RESULTS OF A TWO-YEAR FOLLOW-UP IN REAL CLINICAL PRACTICE CONDITIONS. The Clinician. 2015;9(4):22-27. (In Russ.) https://doi.org/10.17650/1818-8338-2015-9-4-22-27
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