The ClinicianThe ClinicianКлиницист1818-83382412-8775Publishing House ABV Press23010.17650/1818-8338-2015-9-4-22-27ORIGINAL INVESTIGATIONSОРИГИНАЛЬНОЕ ИССЛЕДОВАНИЕLONG-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 CONDITIONSОТДАЛЕННЫЕ ИСХОДЫ У ПАЦИЕНТОВ С ОСТРЫМ КОРОНАРНЫМ СИНДРОМОМ С ПОДЪЕМОМ СЕГМЕНТА ST ПРИ ПРИМЕНЕНИИ ФАРМАКО-ИНВАЗИВНОГО ПОДХОДА И ПЕРВИЧНОГО ЧРЕСКОЖНОГО КОРОНАРНОГО ВМЕШАТЕЛЬСТВА: РЕЗУЛЬТАТЫ ДВУХЛЕТНЕГО НАБЛЮДЕНИЯ В УСЛОВИЯХ РЕАЛЬНОЙ КЛИНИЧЕСКОЙ ПРАКТИКИShilovaA. S.ШиловаА. С.
Russian Federation

Department of Preventive and Emergency Cardiology,

Build. 2, 8 Trubetskaya St., Moscow, 119991

Кафедра профилактической и неотложной кардиологии,

119991, Москва, ул. Трубецкая, 8, стр. 2

a.s.shilova@gmail.comNovikovaN. A.НовиковаН. А.
Russian Federation

Department of Preventive and Emergency Cardiology,

Build. 2, 8 Trubetskaya St., Moscow, 119991

Кафедра профилактической и неотложной кардиологии,

119991, Москва, ул. Трубецкая, 8, стр. 2

ShchekochikhinD. Yu.ЩекочихинД. Ю.
Russian Federation

Department of Preventive and Emergency Cardiology,

Build. 2, 8 Trubetskaya St., Moscow, 119991

Кафедра профилактической и неотложной кардиологии,

119991, Москва, ул. Трубецкая, 8, стр. 2

SyrkinA. L.СыркинА. Л.
Russian Federation

Department of Preventive and Emergency Cardiology,

Build. 2, 8 Trubetskaya St., Moscow, 119991

Кафедра профилактической и неотложной кардиологии,

119991, Москва, ул. Трубецкая, 8, стр. 2

I.M. Sechenov First Moscow State Medical University at the Ministry of Health of RussiaГБОУ ВПО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России151020159422270303201603032016Copyright ©; 2015, Shilova A.S., Novikova N.A., Shchekochikhin D.Y., Syrkin A.L.Copyright ©; 2015, Шилова А.С., Новикова Н.А., Щекочихин Д.Ю., Сыркин А.Л.2015Shilova A.S., Novikova N.A., Shchekochikhin D.Y., Syrkin A.L.Шилова А.С., Новикова Н.А., Щекочихин Д.Ю., Сыркин А.Л.https://creativecommons.org/licenses/by/4.0https://klinitsist.abvpress.ru/Klin/article/view/230

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.

Цель исследования – оценка и сравнение исходов у пациентов с острым коронарным синдромом с подъемом сегмента ST (ОКСспST) в течение 28 мес наблюдения в зависимости от тактики реперфузионной терапии.

Материалы и методы. Исследование основано на внутрибольничном регистре больных с острым коронарным синдромом. В настоящее исследование вошли 259 пациентов с ОКСспST, госпитализированные по каналу скорой медицинской помощи с 1 января 2012 г. по 1 января 2013 г. Проведен сравнительный анализ безопасности и эффективности применения фармако-инвазивного (ФИ) подхода (n = 60) и первичного чрескожного коронарного вмешательства (ЧКВ) (n = 91) через 28 мес наблюдения.

Результаты. Выбор метода реперфузионной терапии (первичное ЧКВ илиФИ-подход) не влиял на выживаемость пациентов втечение 28 мес наблюдения. Прогноз сердечно-сосудистой смертности и заболеваемости в исследуемый период в обеих группах не различался.

Заключение. Применение ФИ-подхода к лечению пациентов с ОКСспST сопоставимо по эффективности и влиянию на отдаленный прогноз с применением первичного ЧКВ в условиях реальной клинической практики.

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