Choice of revascularization method in acute coronary syndrome with non-ST-segment elevation
https://doi.org/10.17802/2306-1278-2021-10-2S-58-62
Abstract
Aim. To analyze the results of various revascularization techniques in high-risk non – STsegment elevation in acute coronary syndromes performed during the first 24 hours.
Methods. As a part of a single-center retrospective study, 45 cases of coronary artery bypass grafting (CABG) were examined in high-risk non – ST-segment elevation in acute coronary syndromes patients during the first 24 hours since their hospitalization for the period from 2017 to 2020. 45 cases of percutaneous coronary intervention (PCI) were selected from a similar group of patients with the help of the copy-pair method.
Results. The groups were comparable according to such significant factors as age, gender, postinfarction cardiosclerosis, diabetes mellitus, and multifocal atherosclerosis. However, the severity of coronary atherosclerosis according to the Syntax score was significantly higher in the CABG group (p = 0.0004). The groups were comparable in achieving complete revascularization (p = 0.2). In 8.9% (n = 4) of patients in the PCI group, unscheduled repeated revascularization was required, and in 15.6% (n = 7) of cases stent restenosis/thrombosis was detected during the hospital period and between PCI stages, while in the CABG group, congenital malformations and dysfunction were not found. Mortality in the groups did not differ significantly (4 (8.8%) versus 2 (4.4%), p = 0.4).
Conclusion. CABG provides freedom from repeated revascularizations, despite the initially more severe coronary lesion.
About the Authors
A. B. Nishonov
Federal State Budgetary Institution “Research Institute for Complex Issues of Cardiovascular Diseases”
Russian Federation
Russian Federation
laboratory assistant researcher at the Laboratory of Endovascular and Reconstructive Heart and Vessel Surgery, Department of Heart and Vessel Surgery,
6, Sosnoviy Blvd., Kemerovo, 650002
R. S. Tarasov
Federal State Budgetary Institution “Research Institute for Complex Issues of Cardiovascular Diseases”
Russian Federation
Russian Federation
M.D., Head of the Laboratory of Endovascular and Reconstructive Heart and Vessel Surgery, Department of Heart and Vessel Surgery,
6, Sosnoviy Blvd., Kemerovo, 650002
References
1. Ayad S.W., Zawawy T.H., Lotfy M.I., Naguib A.M., Amrawy A.M. Incidence and impact of totally occluded culprit coronary artery in patients with non-ST segment elevation myocardial infarction acute coronary syndrome. Egypt Heart J. 2021;73(1):36. doi: 10.1186/s43044-021-00160-x.
2. Desperak P., Hawranek M., Hrapkowicz T., Zembala M.O., Gąsior M. Comparison of multivessel percutaneous coronary intervention and coronary artery bypass grafting in patients with severe coronary artery disease presenting with non-ST-segment elevation acute coronary syndromes. Kardiol Pol. 2018;76(10):1474-1481. doi: 10.5603/KP.a2018.0151.
3. Ram E., Sternik L., Klempfner R., Iakobishvili Z., Peled Y., Shlomo N., Raanani E. Outcomes of different revascularization strategies among patients presenting with acute coronary syndromes without ST elevation. J Thorac Cardiovasc Surg. 2020; 160 (4): 926–935. doi: 10.1016/j.jtcvs.2019.08.130
4. Tarasov R.S., Ivanov S.V., Ganyukov V.I., Sotnikov A.V., Kozyrin K.A., Danilovich A.I., Barbarash L.S. Residual SYNTAX Score following mammary coronary artery bypass: the effects on long-term results. Complex Issues of Cardiovascular Diseases. 2019;8(1):6-14. (In Russian) doi: 10.17802/2306-1278-2019-8-1-6-14
5. Gaba P., Gersh B.J., Ali Z.A., Moses J.W., Stone G.W. Complete versus incomplete coronary revascularization: definitions, assessment and outcomes. Nat Rev Cardiol. 2021;18(3):155-168. doi: 10.1038/s41569-020-00457-5
6. Kim Y.H., Her A.Y., Jeong M.H., Kim B.K., Hong S.J., Kim S., Ahn C.M., Kim J.S., Ko Y.G., Choi D., Hong M.K., Jang Y. Culprit-only versus multivessel or complete versus incomplete revascularization in patients with non-ST-segment elevation myocardial infarction and multivessel disease who underwent successful percutaneous coronary intervention using newer-generation drug-eluting stents. Atherosclerosis. 2020; 301:54-64. doi: 10.1016/j.atherosclerosis.2020.04.002
Review
For citations:
Nishonov A.B., Tarasov R.S. Choice of revascularization method in acute coronary syndrome with non-ST-segment elevation. Complex Issues of Cardiovascular Diseases. 2021;10(2):58-62. (In Russ.) https://doi.org/10.17802/2306-1278-2021-10-2S-58-62
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