Long-term results of delayed endovascular treatment of acute ST-segment elevation myocardial infarction in patients with ectasia of infarct-related coronary artery
Abstract
Objective. To evaluate the safety, short-term and long-term outcomes after delayed and early stenting in patients with acute ST-segment elevation myocardial infarction and ectasia of infarct-related coronary artery.
Material and methods. A multiple-center retrospective study included 80 patients with ST-segment elevation myocardial infarction and ectasia of infarct-related coronary artery between 2014 and 2022. Of these, 50 patients underwent immediate stenting,
and 30 patients underwent delayed intervention.
Results. Delayed stenting for acute ST-segment elevation myocardial infarction in patients with ectasia of infarct-related coronary
artery improves reperfusion data, such as TIMI grade of epicardial coronary blood flow (p=0.02) and myocardial perfusion (MBG
grade) (p<0.001). The same was true for combined angiographic endpoint TIMI-3 and MBG 2-3 (p=0.005), as well as ST segment
resolution ≥70% (p=0.022). After 59 months, the incidence of adverse cardiovascular events was lower after delayed endovascular intervention (p=0.047). This was mainly due to lower risk of hospitalization for CHF (p=0.036) and recurrent myocardial infarction (p=0.179).
Conclusion. Delayed endovascular treatment is safe in patients with acute ST-segment elevation myocardial infarction and ectasia of infarct-related coronary artery. This strategy is also associated with lower risk of adverse cardiovascular events in long-term
period, mainly due to lower incidence of hospitalizations for chronic heart failure.
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