Takotsubo syndrome (TS) is characterized with a reversible disorder of left ventricular contractility. At present time, it is established that various factors, both psycho-emotional and clinical, can trigger this disease. Notably, according to current opinions, coronary atherosclerosis may accompany TS and not be its exclusion criteria as it was previously thought. This article presents a clinical case of TS relapse in a female patient aged 83 years at 5 years following the first episode associated with progression of coronary atherosclerosis.
Despite the low injury of endovascular interventions, there are a number of complications that significantly worsen the prognosis of patients. The most unfavorable complications in patients with ST-segment elevation myocardial infarction during primary percutaneous coronary intervention are stent thrombosis, coronary artery perforation, tamponade, complications at the arterial access site, distal embolism, development of the "no-reflow", stroke. The article is devoted to the study of the frequency of these complications in primary percutaneous coronary intervention in combination with manual thromboaspiration.
Funding Acknowledgements
Type of funding sources: None.
Manual thrombaspiration (MT) is aimed at achieving optimal myocardial perfusion and improving prognosis in patients with ST-segment elevation myocardial infarction (STEMI) undergoing percutaneous coronary interventions.
Purpose. To study the factors influencing the prognosis of the disease in patients with STEMI and massive thrombosis of an infarction-associated artery, who underwent percutaneous coronary intervention in combination with MT.
Materials and methods. 2-year dynamic follow-up of two groups of patients with STEMI: 175 patients undergoing percutaneous coronary intervention with MT and 175 patients with percutaneous coronary intervention without MT.
Results. As a result of the logistic regression analysis by a step-by-step method of including factors (107 indicators in total) that affect the likelihood of developing major adverse coronary event (MACE), the parameters independently influencing the risk of their development were: age of patients over 65 years old (OR 1.9), history of coronary heart disease and MI (OR 3.35), diabetes mellitus (OR 2.54), ischemia time more than 180 minutes (OR 5.43), multivessel coronary artery disease (OR 2.16), absence of myocardial perfusion - MBG grade 0 (OR 39 , 82), the ratio of neutrophils to lymphocytes is more than 3 (OR 11.05). In addition, it was found that with LV ejection fraction at discharge ≤ 42%, the risk of developing BCCS after 48 months. follow-up in both groups was 17.7 times higher (p = 0.00001, OR: 17.7 CI 95%), and in patients in the MTA (+) group with LV EDV of more than 160 ml at discharge from the hospital, the risk of developing MACE after 48 months observation was 7.9 times higher (p = 0.006).
Conclusion. A retrospective analysis of the data obtained showed that all patients with STEMI and massive thrombosis of an infarction-associated coronary artery who died of cardiac causes had predictors of unfavorable outcome, most of which were determined already in the first hours of myocardial infarction.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.