Kilic Salih, Kocabas Umut, Can Levent Hurkan, Yavuzgil Oguz, Zoghi Mehdi
Department of Cardiology, Doctor Ersin Arslan Research and Training Hospital, Gaziantep, Turkey.
Department of Cardiology, Soma State Hospital, Manisa, Turkey.
Cardiol Res. 2018 Feb;9(1):11-16. doi: 10.14740/cr639w. Epub 2018 Feb 11.
It is widely believed that ST-elevated myocardial infarction (STEMI) generally occurs at the site of mild to moderate coronary stenosis. The aim of this study was to determine the degree of stenosis of infarct-related artery (IRA) in STEMI patients who underwent coronary angiography (CAG) after successful reperfusion with thrombolytic therapy (TT).
A total of 463 consecutive patients between January 2008 and December 2013 with acute STEMI treated with TT were evaluated retrospectively. The patients in whom reperfusion failed (n = 120), death occurred before CAG (n = 12), IRA cannot be determined (n = 10), and CAG was not performed in index hospitalization (n = 54) were excluded from the study. To determine the severity of stenosis of IRA, two experienced cardiologists who were unaware of each other used quantitative CAG analysis. Significant stenosis was defined as a ≥ 50% stenosis in the coronary artery lumen. A total of 267 patients who were successfully reperfused with TT and in whom CAG was performed during hospitalization with median 8 (1 - 17) days after myocardial infarction were included in the study.
The mean age of patients was 55.7 ± 10.8 years (85.5% male). Most of the patients had a significant stenosis in IRA ( ≥ 50%, n = 236, group 1) after successful TT; whereas only 11.6% had stenosis < 50% (n = 31, group 2). In addition, majority of the patients had ≥ 70.4% (n = 188, 70.4%) stenosis in IRA. Average of stenosis in IRA was 74±16%.
In contrast to the general opinion, we detected that majority of STEMI patients had a significant stenosis in IRA.
人们普遍认为，ST段抬高型心肌梗死（STEMI）通常发生在轻至中度冠状动脉狭窄部位。本研究旨在确定溶栓治疗（TT）成功再灌注后接受冠状动脉造影（CAG）的STEMI患者梗死相关动脉（IRA）的狭窄程度。
回顾性评估2008年1月至2013年12月期间共463例接受TT治疗的急性STEMI患者。再灌注失败（n = 120）、CAG前死亡（n = 12）、无法确定IRA（n = 10）以及在首次住院期间未进行CAG（n = 54）的患者被排除在研究之外。为确定IRA的狭窄严重程度，两名互不了解情况的经验丰富的心脏病专家采用定量CAG分析。显著狭窄定义为冠状动脉管腔狭窄≥50%。本研究纳入了267例TT成功再灌注且在心肌梗死后中位数8（1 - 17）天住院期间进行CAG的患者。
患者的平均年龄为55.7±10.8岁（男性占85.5%）。大多数患者在TT成功后IRA存在显著狭窄（≥50%，n = 236，第1组）；而只有11.6%的患者狭窄<50%（n = 31，第2组）。此外，大多数患者IRA狭窄≥70.4%（n = 188，70.4%）。IRA的平均狭窄率为74±16%。
与普遍观点相反，我们发现大多数STEMI患者IRA存在显著狭窄。
