Outcomes of patients with acute ST-segment elevation myocardial infarction treated by a prolonged“Deferred”percutaneous coronary intervention strategy  

作　　者：Akshyaya Pradhan Shivam Uppal Pravesh Vishwakarma Abhishek Singh Monika Bhandari Ayush Shukla Akhil Sharma Gaurav Chaudhary Sharad Chandra Rishi Sethi Sudhanshu Kumar Dwivedi 

机构地区：[1]Department of Cardiology,King George’s Medical University,Lucknow 226003,Uttar Pradesh,India [2]Department of Cardiology,Pushpanjali Hospital,Rewari 123401,Haryāna,India [3]Cardiology Centre,King George’s Medical University,Lucknow 226003,Uttar Pradesh,India

出　　处：《World Journal of Cardiology》2025年第2期52-60,共9页世界心脏病学杂志(英文)

摘　　要：BACKGROUND Primary percutaneous coronary intervention(PCI)is the preferred treatment for ST-segment elevation myocardial infarction(STEMI).However,in patients with high thrombus burden,immediate stenting during PCI can lead to poor outcomes due to the risk of thrombus migration and subsequent microvascular occlusion,resulting in no-reflow phenomena.Deferred stenting offers a potential advantage by allowing for the reduction of thrombus load,which may help to minimize the incidence of slow-flow and no-reflow complications.This study explores the effectiveness of a deferred stenting strategy in improving outcomes for STEMI patients.AIM To evaluate the effectiveness and safety of deferred PCI in a real-world setting in acute STEMI patients.METHODS RESULTS Anterior wall myocardial infarction was the predominant type of STEMI in 62%of the selected 55 patients(mean age:54 years;70%males),and diabetes mellitus was the most common risk factor(18.2%),followed by hypertension(16.2%).On the second angiogram of these patients measures of thrombus grade,thrombolysis in myocardial infarction flow grade,myocardial blush grade,and severity of stenosis of culprit lesion were consid-erably improved compared to the first angiogram,and the average culprit artery diameter had increased by 7.8%.Most patients(60%)had an uneventful hospital stay during the second angiogram and an uneventful intrapro-cedural course(85.19%),with slow-flow/no-reflow occurring only in 7.4%of the patients;these patients recovered after taking vasodilator drugs.In 29.3%of patients,the culprit artery was recanalized,preventing unnecessary stent deployment.CONCLUSION Deferred PCI strategy is safe and reduces the thrombus burden,improves thrombolysis in myocardial infarction(TIMI)flow,improves myocardial blush grade,and prevents unwarranted stent deployment.

关 键 词：Myocardial infarction Percutaneous coronary intervention ST elevation myocardial infarction STENTS Coronary angiography 

分 类 号：R54[医药卫生—心血管疾病]