FACTORS OF MORTALITY IN ST-ELEVATION MYOCARDIAL INFARCTION PATIENTS WITH MULTIVESSEL CORONARY DISEASE AFTER ENDOVASCULAR REVASCULARIZATION

Purpose. To identify demographic and clinical-anatomic and angiographic factors associated with fatal outcome after primary percutaneous coronary intervention (PCI) in patients with ST-elevation myocardial infarction (STEMI) and multivessel disease (MVD) of coronary arteries within 12 months. Materials and methods. The study included 327 consecutive patients with STEMI and MVD of coronary arteries who received primary PCI. Clinical, demographic and angiographic characteristics of the patients and strategies of revascularization were analyzed. All patients were divided in two groups: (1) Fatal outcome (n=17), and (2) No fatal outcome (n=310). The structure and causes of 30 day and 12 months fatality outcomes were studied. Results. The most significant clinical and demographic factors of fatal outcome after revascularization were: older age 66,6± ±8,2 years (p=0,006); reduction of left ventricular ejection fraction (LVEF) - 46,2±4,5 % (p=0,02); myocardial infarction in past - in 35,3 % of patients (p=0,04); acute heart failure manifestation (Killip 2) - in 29,4 % of patients (p=0,05). Anatomic and angiographic factors of mortality were: unsuccessful PCI (final blood flow in the target artery less than TIMI3 and \ or the presence of significant complications) (p=0,0001) and the initial severity of coronary lesions on the SYNTAX score (p=0,03). Conclusions. Assessment of clinical-demographic, anatomic and angiographic factors allows to identify MVD STEMI patients with a high risk of death after primary PCI to use optimal strategies of revascularization and medical therapy for this high-risk patients.

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