The effect of therapy on the clinical course of acute myocardial infarction with st-segment elevation in patients after percutaneous coronary intervention
DOI:
https://doi.org/10.15587/2519-4798.2019.155448Keywords:
the phenomenon of no-reflow, IMEST, ranolazine, querсetinAbstract
The aim: to investigate the effectiveness of the use of ranolazine and quercetin in patients with acute IMEST after percutaneous coronary intervention and their impact on long-term results of treatment.
Materials and methods: The study involved 105 patients with acute myocardial infarction with ST-segment elevation, who underwent percutaneous coronary intervention. Patients were divided into three study groups: patients who received standard medical therapy (control group), patients who were prescribed an intravenous form of quercetin according to the scheme (Basic 1) and patients received oral form of ranolazine according to the standard therapy (Basic 2). The state of myocardial perfusion after PCI, EchoCG, KDI, CSI and FV dynamics, and long-term results of treatment after 1 year were evaluated. The combined endpoint included a non-fatal recurrent myocardial infarction, a nonfatal stroke, a second hospitalization for angina reflux, and a sudden cardiovascular death.
Results. Analyzing the state of myocardial perfusion in patients of the studied groups, it was found that in 18 patients (17.1%) the degree of restoration of blood flow at the level of microcirculation remained unsatisfactory. EchoCG after 9.3±1.2 days after PCI showed less KDI in the Primary 2 group and less CSI in the Primary 1 group compared with the control group (p<0.05). After 8.3±0.6 months CSI and KDI in the Primary 1 and Primary 2 groups, respectively, remained lower, and the EF in the Primary 1 group was higher than in the control group. A decrease in the frequency of onset of the total combined endpoint in the group of patients with FNC (OR=0.029; CI: 0.001–0.574; p<0.05) was recorded. Patients of the Primary 2 group had a lower re-hospitalization rate for angina pectoris (OR = 0.158; CI: 0.032–0.777; p <0.05) and the frequency of reaching the combined end point for the group as a whole (OR=0.244; CI: 0.081 0.730; p<0.05), as well as among patients with poor myocardial perfusion after PCI (OR=0.048; CI: 0.002–1.041; p<0.05).
Conclusions: ranolazine and quercetin in patients with acute myocardial infarction contributes to the positive dynamics of KDI, XI and FV. Ranolazine and querсetin reduces the frequency of repeated hospitalizations for the renewal of angina during the year
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