Русский
Clinical course of repeated myocardial infarction in previously stented patients
DOI: https://dx.doi.org/10.18565/therapy.2023.10.60-66
Lutsik E.A., Skorodumova E.A., Kostenko V.A., Skorodumova E.G., Siverina A.V.
1) Vsevolozhsky Clinical Interdistrict Hospital; 2) I.I. Dzhanelidze Saint Petersburg Research Institute of Emergency Medicine
The aim: to compare the peculiarities of recurrent MI clinical course in patients with thrombosis/stenosis in a previously installed stent and obstruction of coronary artery outside it in addition to the progression of atherosclerosis.
Material and methods. Patients with recurrent MI who underwent stenting of the infarct-related coronary artery during the previous and current hospitalization were studied. They were divided into two groups: 1st – 110 persons with thrombosis/stenosis in the stent, 2nd – 102 persons with stenosis outside the previously installed stent. The participants had predominantly male gender; average age of them was 66,4±1,2 years old.
Results. Reinfarction in patients in group 1 developed on average after 3,9 years, in group 2 – after 5,5 years (p=0,04). Type 2 diabetes mellitus and chronic kidney disease were more common in group 1. In 90,8% of patients in the total sample, mostly large arteries were stenotic. Patients in group 2 were characterized by multi-vessel coronary lesions (p=0,03). LVEF in patients of group 1 was on average lower than in patients of group 2. Patients in group 1 had higher levels of large platelets and thrombocrit indexes, a significantly higher level of CRP and worse renal function. A high level of LDL cholesterol as a potential factor of atherosclerosis progression and significantly lower level of HDL cholesterol in the blood at the time of intervention and later could stimulate a more active development of atherosclerosis precisely at the site of stent implantation. Hospital mortality was 3 times higher in patients of group 1 comparatively to patients of group 2.
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About the Autors
Ekaterina A. Lutsik, cardiologist, head of the patients risk management center of the outpatient clinic of Vsevolozhsky Clinical Interdistrict Hospital. Address: 188640, Leningrad region, Vsevolozhsk, 20 Koltushskoe Highway.
E-mail: Ekaterina.lytsik@yandex.ru
ORCID: https://orcid.org/0009-0006-0038-1773
Elena A. Skorodumova, MD, leading researcher at the Department of emergency cardiology and rheumatology, I.I. Dzhanelidze Saint Petersburg Research Institute of Emergency Medicine. Address: 192242, Saint Petersburg, 3 lit. A Budapestskaya St.
E-mail:elskor@mail.ru
ORCID: https://orcid.org/0000-0002-5017-0214
Viktor A. Kostenko, MD, head of the Department of emergency cardiology and rheumatology, I.I. Dzhanelidze Saint Petersburg Research Institute of Emergency Medicine. Address: 192242, Saint Petersburg, 3 lit. A Budapestskaya St.
Email: vic2012tor@gmail.com
ORCID: https://orcid.org/0000-0002-7015-1010
Elizaveta G. Skorodumova, PhD in Medical Sciences, junior researcher at the Department of emergency cardiology and rheumatology, I.I. Dzhanelidze Saint Petersburg Research Institute of Emergency Medicine. Address: 192242, Saint Petersburg, 3 lit. A Budapestskaya St.
E-mail: lisavetta91@mail.ru
ORCID: https://orcid.org/0000-0002-4961-5570
Anna V. Siverina, PhD in Medical Sciences, researcher at the Department of emergency cardiology and rheumatology, I.I. Dzhanelidze Saint Petersburg Research Institute of Emergency Medicine. Address: 192242, Saint Petersburg, 3 lit. A Budapestskaya St.
E-mail: gudkovanna_09@mail.ru
ORCID: https://orcid.org/0000-0002-6831-2153
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