Volume 3, Issue 4, December 2019, Page: 99-103
Short Term Follow up for Diabetic Patients Presented with Acute STEMI Undergoing Preventive Versus Culprit Lesion in Primary Percutaneous Coronary Intervention
Mohamed Elsayed Shuman, Cardiology Department, National Heart Institute, Cairo, Egypt
Ahmed Abdallah Mostafa, Cardiology Department, Police Academy Center, Cairo, Egypt
Ghada Mahmoud Soltan, Cardiology Department, Faculty of Medicine, Menofia Unversity, Al Minufya, Egypt
Abdalla Mostafa Kamal, Cardiology Department, Faculty of Medicine, Menofia Unversity, Al Minufya, Egypt
Received: Nov. 2, 2019;       Accepted: Nov. 23, 2019;       Published: Dec. 4, 2019
DOI: 10.11648/j.ccr.20190304.15      View  483      Downloads  151
Abstract
Objectives: This study aimed to evaluate the short term follow up for diabetic patients presented with acute STEMI underwent preventive percutaneous coronary intervention. Background: preventive PCI appears to be safe as culprit artery PCI with effective reduction of refractory angina and repeated revascularization in selected patients but no benefit on mortality or recurrent MI. Methods: Our study was a prospective, observational study conducted at multicenter hospitals included 120 diabetic patients admitted with acute STEMI and multivessels CAD at National Heart Institute, Menofia university hospital, police academy center and some private hospitals patients from June 2017 to august 2018, group (A) Consisted of 70 diabetic patients with acute STEMI undergone preventive PCI in whom PCI will be done for culprit & non culprit lesions, group (B) Consisted of 50 diabetic patients with acute STEMI undergone PCI for culprit lesion only. Results: The total revascularization group were significantly less suffering from refractory angina 5 (7.1%) vs 15 (30.0%), p= <0.001 and less re-hospitalized for cardiac causes 14 (20.0%) vs 22 (44.0%), p= 0.005, cardiac mortality was 2 patients 0 (0.0%) vs 2 (4%) p= 0.092. Conclusion: The preventive PCI appears to be safe as culprit artery PCI with effective reduction of refractory angina and repeated revascularization but no benefit on mortality or recurrent MI in selected hemodynamically stable STEMI diabetic patients with multivessel disease.
Keywords
STEMI, Multivessels CAD, Preventive PCI
To cite this article
Mohamed Elsayed Shuman, Ahmed Abdallah Mostafa, Ghada Mahmoud Soltan, Abdalla Mostafa Kamal, Short Term Follow up for Diabetic Patients Presented with Acute STEMI Undergoing Preventive Versus Culprit Lesion in Primary Percutaneous Coronary Intervention, Cardiology and Cardiovascular Research. Vol. 3, No. 4, 2019, pp. 99-103. doi: 10.11648/j.ccr.20190304.15
Copyright
Copyright © 2019 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Reference
[1]
A. R. Santos, B. C. Pi ̧carra, M. Celeiroetal. Multi-vessel approach in ST- elevation myocardial infarction: Impact on in-hospital morbidity and mortality. Rev Port Cardiol. 2014; 33: 67-73.
[2]
Bhatt DL, Eagle KA, Ohman EM, et al; REACH Registry Investigators. Comparative determinants of 4-year cardiovascular event rates in stable outpatients at risk of or with atherothrombosis. JAMA. 2010; 304: 1350–1357. doi: 10.1001/jama.2010.1322.
[3]
Bates E. R. Tamis-Holland J E, Bittl JA, et al. PCI Strategies in Patients with ST-Segment Elevation Myocardial Infarction and Multi-vessel Coronary Artery Disease. J Am CollCardiol. 2016; 68 (10): 1066–81.
[4]
Gershlick AH, Khan JN, Kelly DJ, et al. Randomized trial of complete versus lesion-only revascularization in patients under- going primary percutaneous coronary intervention for STEMI and multi-vessel Disease: the CvLPRIT trial. J Am CollCardiol. 2015; 65: 963–72.
[5]
Goldstein JA, Demetriou D, Grines CL, et al. Multiple complex coronary plaques in patients with acute myocardial infarction. N Engl J Med, 2000; 343: 915–922.
[6]
Kalarus Z, Lenarczyk R, Kowalczyk J, et al. Importance of complete revascularization in patients with acute myocardial infarction treated with percutaneous coronary intervention. Am Heart J 2007; 153: 304-312.
[7]
Keeley EC, Boura JA and Grines CL. Primary angioplasty versus intravenous thrombolytic therapy for acute myocardial infarction: a quantitative re- view of 23 randomized trials. Lancet. 2003; 361: 13–20.
[8]
Lee HW, Hong TJ, Yang Mi J, et al. Comparison of infarct- related artery vs multivessel revascularization in ST-segment elevation myocardial infarction with multivessel disease: analysis from Korea Acute Myocardial Infarction registry (KAMIR). Cardiol J 2012; 19, 3: 256-266.
[9]
Levine GN, O’Gara PT, Bates ER, et al. 2015 ACC/AHA/SCAI focused update on primary percutaneous coronary intervention for patients with ST- elevation myocardial infarction: an update of the 2011 ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention and the 2013 ACCF/AHA Guideline for the Management of ST- Elevation Myocardial Infarction. J Am Coll Cardiol 2015; 67: 1235–50.
[10]
Mc Cann G, Khan JN, Greenwood JP, et al. Complete Versus Lesion- Only Primary PCI The Randomized Cardiovascular MR CvLPRIT Sub study. J Am Coll Cardiol 2015; 66: 2713–24.
[11]
Muller DW, Topol EJ, Ellis SG, et al. Multivessel coronary artery disease: a key predictor of short- -term prognosis after reperfusion therapy for acute myocardial infarction (TAMI) Study Group. Am Heart J, 1991; 121: 1042–1049.
[12]
Nallamothu BK, Hayward RA, Bates ER. Beyond the randomized clinical trial: the role of effectiveness studies in evaluating cardiovascular therapies. Circulation 2008; 118: 1294–303.
[13]
O’Gara PT, Kushner FG, Ascheim DD, et al. 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation. 2013; 127: 529–55.
[14]
Qarawani D, Nahir M, Abboud M, et al. Culprit only versus complete coronary revascularization during primary PCI. Int J Cardiol. 2008; 123: 288–92.
[15]
Sorajja P, Gersh BJ, Cox DA, et al. Impact of multi-vessel disease on reperfusion success and clinical outcomes in patients undergoing primary percutaneous coronary intervention for acute myocardial infarction. Eur Heart J 2007; 28: 1709–16.
[16]
Steg PG, James SK, AtarD, et al. ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation. Eur Heart J 2012; 33 (20): 2569-2619.
[17]
Vlaar PJ, Mahmoud KD, Holmes DR, et al. Culprit vessel only versus multi-vessel and staged percutaneous coronary intervention for multi-vessel disease in patients presenting with ST-segment elevation myocardial infarction: a pairwise and network meta-analysis. J Am Coll Cardiol. 2011; 58: 692–703.
[18]
Widimsky P, Holmes DR, Jr. How to treat patients with ST elevation acute myocardial infarction and multi-vessel disease? Eur Heart J 2011; 32: 396-403.
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