PHARMACOINTERVENTIONAL TACTICS OF MYOCARDIAL INFARCTION TREATMENT

Study objective was to conduct a prospective observational study to assess the effect of pharmacointerventional tactics on the outcome of acute ST-elevation myocardial infarction (STEMI) in terms of mortality.

MATERIAL AND METHODS. The study included 405 patients with acute STEMI. The Thrombolysis in Myocardial Infarction (TIMI) Risk Score was used to assess the coronary circulation recovery in a major epicardial coronary artery (CA). Percutaneoous coronary interventions (PCIs) were undertaken either as initial interventions, or in a framework of pharmacointervantional treatment tactics.

RESULTS. Among 405 patients with STEMI, 154 (38%) underwent a thrombolytic therapy (TLT). Coronarography performed within 24 h from the onset of disease clinical symptoms demonstrated a completely occluded CA that had supplied blood to the area of present infarction in 73% of patients without previous TLT and in 74% of patients after TLT. TLT proved to be effective only in 36 % of patients. A successful revascularization, compared to that of inefficient, reduced the relative all-cause mortality risk and MI-caused mortality risk in the initially high-risk patients by 74% and 78 %, respectively.

concLusIons A timely myocardium revascularization using PCI is effective after successfully performed TLT. This proves the benefit of pharmacointerventional treatment tactics for the patients with STEMI in the cases when initial PCI appeared impossible for some reasons. 

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