Optimal management of patients with ST-segment elevation myocardial infarction with delayed admission to the percutaneous coronary intervention center (more than 12 hours)

The success of myocardial infarction (MI) treatment largely depends on the timely delivery of quality health care, primarily on the blood flow restoration through the infarct-related artery. This review presents the results of several meta-analyzes and studies, including our own data, which indicate...

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Main Authors: S. A. Vorontsova, T. V. Pavlova, S. M. Khokhlunov, A. A. Podlipaeva
Format: Article
Language:Russian
Published: «FIRMA «SILICEA» LLC 2021-10-01
Series:Российский кардиологический журнал
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Online Access:https://russjcardiol.elpub.ru/jour/article/view/4518
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author S. A. Vorontsova
T. V. Pavlova
S. M. Khokhlunov
A. A. Podlipaeva
author_facet S. A. Vorontsova
T. V. Pavlova
S. M. Khokhlunov
A. A. Podlipaeva
author_sort S. A. Vorontsova
collection DOAJ
description The success of myocardial infarction (MI) treatment largely depends on the timely delivery of quality health care, primarily on the blood flow restoration through the infarct-related artery. This review presents the results of several meta-analyzes and studies, including our own data, which indicate that delayed revascularization (>12 h from the onset) performed in patients with ST-segment elevation MI leads to an increase in the short- and long-term survival, a decrease in the incidence of cardiovascular events and severity of myocardial remodeling. For example, the analysis from the V. P. Polyakov Samara Regional Clinical Cardiological Dispensary showed the higher mortality rate in patients with ST-segment elevation MI admitted >12 hours from the onset, who received conservative treatment (7,9%) than in those with the invasive management (0,5%) (hazard ratio, 14,8; 95% confidence interval, 1,7- 124,7; P<0,05). However, at present, there is no complete clarity regarding the strategy of managing such patients. According to the current European Society of Cardiology guidelines on myocardial revascularization (2018), the class of recommendations reaches IIA, which means the conflicting data and/ or disagreement about usefulness/efficacy of a particular treatment method, but weight of evidence/opinion is in favor of usefulness/efficacy.
format Article
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institution DOAJ
issn 1560-4071
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language Russian
publishDate 2021-10-01
publisher «FIRMA «SILICEA» LLC
record_format Article
series Российский кардиологический журнал
spelling doaj-art-62874c613fb649b99941fa08ca506c3c2025-08-20T02:59:04Zrus«FIRMA «SILICEA» LLCРоссийский кардиологический журнал1560-40712618-76202021-10-01263S10.15829/1560-4071-2021-45183343Optimal management of patients with ST-segment elevation myocardial infarction with delayed admission to the percutaneous coronary intervention center (more than 12 hours)S. A. Vorontsova0T. V. Pavlova1S. M. Khokhlunov2A. A. Podlipaeva3Samara State Medical University; V.P. Polyakov Samara Regional Clinical Cardiology DispensarySamara State Medical University; V.P. Polyakov Samara Regional Clinical Cardiology DispensarySamara State Medical University; V.P. Polyakov Samara Regional Clinical Cardiology DispensarySamara State Medical UniversityThe success of myocardial infarction (MI) treatment largely depends on the timely delivery of quality health care, primarily on the blood flow restoration through the infarct-related artery. This review presents the results of several meta-analyzes and studies, including our own data, which indicate that delayed revascularization (>12 h from the onset) performed in patients with ST-segment elevation MI leads to an increase in the short- and long-term survival, a decrease in the incidence of cardiovascular events and severity of myocardial remodeling. For example, the analysis from the V. P. Polyakov Samara Regional Clinical Cardiological Dispensary showed the higher mortality rate in patients with ST-segment elevation MI admitted >12 hours from the onset, who received conservative treatment (7,9%) than in those with the invasive management (0,5%) (hazard ratio, 14,8; 95% confidence interval, 1,7- 124,7; P<0,05). However, at present, there is no complete clarity regarding the strategy of managing such patients. According to the current European Society of Cardiology guidelines on myocardial revascularization (2018), the class of recommendations reaches IIA, which means the conflicting data and/ or disagreement about usefulness/efficacy of a particular treatment method, but weight of evidence/opinion is in favor of usefulness/efficacy.https://russjcardiol.elpub.ru/jour/article/view/4518acute myocardial infarctionst-segment elevation acute coronary syndromepercutaneous coronary interventionrevascularization
spellingShingle S. A. Vorontsova
T. V. Pavlova
S. M. Khokhlunov
A. A. Podlipaeva
Optimal management of patients with ST-segment elevation myocardial infarction with delayed admission to the percutaneous coronary intervention center (more than 12 hours)
Российский кардиологический журнал
acute myocardial infarction
st-segment elevation acute coronary syndrome
percutaneous coronary intervention
revascularization
title Optimal management of patients with ST-segment elevation myocardial infarction with delayed admission to the percutaneous coronary intervention center (more than 12 hours)
title_full Optimal management of patients with ST-segment elevation myocardial infarction with delayed admission to the percutaneous coronary intervention center (more than 12 hours)
title_fullStr Optimal management of patients with ST-segment elevation myocardial infarction with delayed admission to the percutaneous coronary intervention center (more than 12 hours)
title_full_unstemmed Optimal management of patients with ST-segment elevation myocardial infarction with delayed admission to the percutaneous coronary intervention center (more than 12 hours)
title_short Optimal management of patients with ST-segment elevation myocardial infarction with delayed admission to the percutaneous coronary intervention center (more than 12 hours)
title_sort optimal management of patients with st segment elevation myocardial infarction with delayed admission to the percutaneous coronary intervention center more than 12 hours
topic acute myocardial infarction
st-segment elevation acute coronary syndrome
percutaneous coronary intervention
revascularization
url https://russjcardiol.elpub.ru/jour/article/view/4518
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AT tvpavlova optimalmanagementofpatientswithstsegmentelevationmyocardialinfarctionwithdelayedadmissiontothepercutaneouscoronaryinterventioncentermorethan12hours
AT smkhokhlunov optimalmanagementofpatientswithstsegmentelevationmyocardialinfarctionwithdelayedadmissiontothepercutaneouscoronaryinterventioncentermorethan12hours
AT aapodlipaeva optimalmanagementofpatientswithstsegmentelevationmyocardialinfarctionwithdelayedadmissiontothepercutaneouscoronaryinterventioncentermorethan12hours