KLINIČKI REZULTATI PERKUTANOG LEČENJA STENOZE NA GLAVNOM STABLU LEVE KORONARNE ARTERIJE U AKUTNOM INFARKTU MIOKARDA
Sažetak
Uvod: Akutni infarkt miokarda izazvan lezijom na glavnom stablu leve koronarne arterije je redak ali katastrofalan događaj, često povezan sa iznenadnim smrtnim ishodom i/ili kardiogenim šokom. Optimalna strategija za revaskularizaciju ovih pacijenata je i dalje predmet debate, pogotovo u urgentnim situacijama gde je neophodno brzo osigurati optimalni angiografski rezultat kako bismo poboljšali prognozu bolesnika.
Cilj rada: Cilj ovog rada je da istraži karakteristike pacijenata, proceduralne i kliničke varijable kao prediktore ishoda nakon perkutane koronarne intervencije kod bolesnika sa akutnom lezijom na glavnom stablu leve koronarne arterije.
Materijal i metode: Retrospektivno je analizirano 40 pacijenata sa akutnim infarktom miokarda usled lezije na glavnom stablu, kojima je rađena perkutana koronarna intervencija, u periodu od 01.01.2019. do 21.12.2022. godine.
Rezultati: Prosek godina ispitivane populacije, koju je činilo 40 pacijenata, je bio 70,83±11,415. Kardiogeni šok je bio prisutan kod njih 20 (50%). Tokom procedure su preminula 2 pacijenta (5%), a tokom hospitalizacije njih 16 (40%). Od 22 pacijenta koji su uspešno otpušteni sa bolničkog lečenja, pet pacijenata je preminulo tokom perioda praćenja. Ukupni mortalitet je bio 23 (57,5%). Faktori povezani sa povećanim mortalitetom uključuju ženski pol (p=0,008), kardiogeni šok (p=0,025) i primena inotropne potpore u toku hospitalizacije (p=0,000).
Zaključak: Akutni infarkt miokarda izazvan lezijom na glavnom stablu leve koronarne arterije je praćen visokom učestalošću kardiogenog šoka i stopom hospitalnog i udaljenog mortaliteta. Uprkos visokoj stopi proceduralne uspešnosti perkutane procedure, mortalitet ovih bolesnika je i dalje visok.
Ključne reči: akutni infarkt miokarda; perkutana koronarna intervencija; glavno stablo leve koronarne arterije
Reference
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