Shemirani Hassan, Zavar Reihaneh, Khosravi Alireza, Tavakoli Maryam
Department of Cardiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
Heart Views. 2021 Jul-Sep;22(3):184-188. doi: 10.4103/HEARTVIEWS.HEARTVIEWS_216_20. Epub 2021 Oct 11.
The relation between left anterior descending artery (LAD) anatomy and clinical outcomes in patients with anterior ST-segment elevation myocardial infarction (STEMI) has not been fully investigated. The aim of this study was to determine the frequency and severity of short-term cardiovascular outcomes in patients with Anterior ST-Segment Elevation Myocardial Infarction (STEMI) undergoing primary percutaneous intervention (PCI), based on wraparound and non-wraparound left anterior descending artery (LAD).
In a cross-sectional study, 126 patients with anterior STEMI who were admitted to Shahid Chamran Hospital in Isfahan during 2020 were studied. Patients were evaluated for anatomical features of LAD coronary artery and clinical outcomes determined and compared based on wraparound LAD and non-wraparound LAD during hospitalization and up to one month after PCI.
The prevalence of wraparound LAD in the studied patients was 73% and left ventricular systolic dysfunction in admission was greater and more severe in patients with wraparound LADs compared with those with non-wraparound. Severe LV systolic dysfunction in the wraparound and non-wraparound groups was 39.6% and 8.8%, respectively ( < 0.001). Also, the frequency of arrhythmias in the wraparound group (21.7%) was higher than the non-wraparound group (5.9%) ( = 0.037).
The patients with anterior STEMI and wraparound LAD have a worse clinical outcome and more severe left ventricular systolic dysfunction. Therefore, it seems that the study of the anatomical condition of the LAD artery at the time of angiography is of great importance in the way of observation and care, and treatment of patients.
前降支动脉（LAD）解剖结构与前壁ST段抬高型心肌梗死（STEMI）患者临床结局之间的关系尚未得到充分研究。本研究的目的是基于左旋支和非左旋支的左前降支动脉（LAD），确定接受直接经皮冠状动脉介入治疗（PCI）的前壁ST段抬高型心肌梗死（STEMI）患者短期心血管结局的频率和严重程度。
在一项横断面研究中，对2020年期间入住伊斯法罕沙希德·查姆兰医院的126例前壁STEMI患者进行了研究。对患者的LAD冠状动脉解剖特征进行评估，并根据左旋支LAD和非左旋支LAD在住院期间以及PCI后长达1个月的时间内确定和比较临床结局。
研究患者中左旋支LAD的患病率为73%，与非左旋支患者相比，左旋支LAD患者入院时左心室收缩功能障碍更严重。左旋支和非左旋支组的严重左心室收缩功能障碍分别为39.6%和8.8%（<0.001）。此外，左旋支组的心律失常发生率（21.7%）高于非左旋支组（5.9%）（P = 0.037）。
前壁STEMI合并左旋支LAD的患者临床结局较差，左心室收缩功能障碍更严重。因此，在观察、护理和治疗患者的过程中，似乎在血管造影时研究LAD动脉的解剖状况非常重要。
