Immediate results of delayed percutaneous coronary interventions in patients with acute coronary syndrome

Objective. Percutaneous coronary interventions (PCI) have long been an effective tool in the treatment of acute coronary syndromes (ACS), and timely interventions in such patients have great importance. However, due to socio-economic difficulties, it is not always possible to treat adequately this acute condition, in accordance with established international criteria. This gives an opportunity to investigate the results of the practical approach to delayed percutaneous coronary interventions in patients with acute coronary syndrome. Purpose. Evaluate the immediate results of delayed percutaneous coronary interventions in patients with acute coronary syndrome. Methods. In this study were included patients with ACS who received coronary angiography with stenting of coronary arteries («acute» PCI group, 42 patients), patients who were treated by medical therapy for ACS in the hospital without possibility of PCI (50 patients), and medically stabilized patients after ACS, which were given for angiography and PCI. (average, 30 days after ACS, 49 patients). The groups did not differ in basic demographic and clinical characteristics. Standard clinical, electrocardiographic (ECG) and echocardiographic (ECH0) data were evaluated. Results. In the PCI groups, angiographic success was achieved in 100%. The average time from the symptoms onset to PCI in the «acute» group was 89.4 hours. In the «acute» group, mortality was 3 patients (7.1%), and in the medical therapy group, mortality was 18% (p <0,05). In the «acute» group two patients had cardiac adverse events, and at presented they had a cardiogenic shock symptoms, one patient died from complications due to major bleeding. The positive dynamics of ST segment recovery on the ECG and ECH0 parameters was more pronounced in the «acute» PCI group. Conclusions. Despite on the time delay, PCI in ACS is more effective method of restoring myocardial function even in comparison with patients who received early thrombolysis.