Предикторы эффективности и безопасности чрескожных коронарных вмешательств у больных с острым коронарным синдромом

The purpose of research: the appraisal of safety and efficacy of PCI in patients with ACS. Methods. There have been investigated 75 patients having ACS with and without elevation of ST-segment on ECG. All patients have been treated to PCI with stenting of culprit vessel. The followup period was timed to 6-18 months. The criteria of efficacy and safety have been evaluated. The primary efficacy end point was common death, death from cardiovascular causes, nonfatal myocardial infarction, re-hospitalization for angina pectoris, target vessel revascularization. The safety has been evaluated by the amount of complications happening during or immediately after PCI. 36 clinical, anamnestic, laboratory and instrumental characteristics have been evaluated at admission for finding safety and efficacy predictors. Results and conclusions. As a result the following predictors are the most important for efficacy: incomplete revascularization, arrhythmia, premature discontinuation of thienopyridine therapy after drug-eluting stent placement, and female sex. The most important predictors as to complications are prior myocardial infarction, left anterior descending artery lesion, and high erythrocyte sedimentation rate. As a result of discriminant analysis there have been found two equations which results in 76% and 88% exact prognosis for safety and efficacy of PCI: 1) for efficacy: DF1 = 3,7-incomplete revascularization 4,3-clopidogrel 2-arrythmia 2,2-female 2,7; 2) for safety: DF = 6-prior MI 0,07-ESR 2,5-LADa 9.