Tarasov R S, Ganyukov V I, Protopopov A V, Barbarash O L, Barbarash L S
Research Institute for Complex Problems of Cardiovascular Diseases, Kemerovo, Russia.
Regional Clinical Hospital, Krasnoyarsk, Russia.
Kardiologiia. 2017 Mar;57(3):25-30.
Lack of evidence base on the use of 2-nd generation drug covered stents in patients with ST-elevation myocardial infarction (STEMI) with multivessel lesions in coronary vascular bed makes it important to conduct studies of new devices in a framework of multivessel stenting in primary percutaneous coronary intervention (PPCI) and staged revascularization. Controversial data on outcomes of the strategy of multiple revascularization in STEMI might be related to the use of previous generation coronary stents in this category of patients. Aim of this study was assessment of one year outcomes of multivessel stenting in a framework of PPCI and staged revascularization (8.6+/-4.2 days between stages) with the use of 2-nd generation drug covered stents. We showed that both multivessel stenting and staged revascularuzation might be effective options of revascularization in STEMI with the use of 2-nd generation drug covered stents and maintenance of limited time interval between PCI on infarct related artery and PCI on other coronary vessels with significant stenotic lesions. This strategy was associated with low rate of adverse cardiovascular events.
在冠状动脉床存在多支血管病变的ST段抬高型心肌梗死（STEMI）患者中，缺乏关于使用第二代药物涂层支架的循证依据，这使得在直接经皮冠状动脉介入治疗（PPCI）和分期血运重建的多支血管支架置入框架内开展新器械研究变得至关重要。STEMI患者多次血运重建策略的结果存在争议的数据，可能与在此类患者中使用上一代冠状动脉支架有关。本研究的目的是评估在PPCI和分期血运重建（分期之间间隔8.6±4.2天）框架内使用第二代药物涂层支架进行多支血管支架置入的一年结果。我们表明，使用第二代药物涂层支架，以及在梗死相关动脉的PCI与其他存在严重狭窄病变的冠状动脉血管的PCI之间维持有限的时间间隔时，多支血管支架置入和分期血运重建可能都是STEMI血运重建的有效选择。该策略与不良心血管事件发生率较低相关。
