ORIGINAL RESEARCH
Interventional Cardiology
doi: 10.25005/2074-0581-2024-26-3-387-398
STRATIFIED APPROACH TO PREVENTION OF NO-REFLOW PHENOMENON DURING ENDOVASCULAR TREATMENT OF PATIENTS WITH ST-ELEVATION MYOCARDIAL INFARCTION

E.YU. BESSONOV1, A.N. SHISHKEVICH2,3, S.S. MIKHAYLOV2,3, V.N. KRAVCHUK2,3

1Department of Endovascular Methods of Diagnosis and Treatment, Alexander Hospital, St. Petersburg, Russian Federation
21st Department of Advanced Training Surgery, Military Medical Academy named after C.M. Kirov, St. Petersburg, Russian Federation
3Department of Cardiovascular Surgery, North-Western State Medical University named after I.I. Mechnikov, St. Petersburg, Russian Federation

Objective: To develop and test an algorithm for no-reflow phenomenon (NRP) prevention during endovascular treatment of patients with ST-elevation myocardial infarction (STEMI)

Methods: A prospective single-center randomized study included 100 patients diagnosed with STEMI who underwent coronary artery stenting. Group 1 included 50 patients who were operated using an algorithm for the NRP prevention, while Group 2 included 50 patients who underwent routine transluminal balloon angioplasty and stenting of the coronary arteries. The NRP risk was assessed using the predictive model by Wang JW et al

Results: Both groups were comparable in terms of anamnestic and clinical data, biochemical and instrumental examination results. High NRP risk was determined in 36% of Group 1 patients and 40% of Group 2 patients. NRP developed significantly less often in Group 1 patients compared to Group 2 (14% vs. 36%, p=0.01). Worsening of Killip class of acute heart failure was found significantly less common in Group 1 patients compared to Group 2 (2% versus 16%, p=0.03)

Conclusion: The proposed algorithm for NRP prevention increased the effectiveness of treatment for STEMI

Keywords: ST-elevation myocardial infarction, myocardial revascularization, percutaneous coronary intervention, no-reflow phenomenon.

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Authors' information:

Bessonov Evgeniy Yurievich,
Endovascular Surgeon, Department of Endovascular Methods of Diagnosis and Treatment, Alexander Hospital
ORCID ID: 0000-0003-2960-6543
E-mail: ewgenijbessonov@yandex.ru

Shishkevich Andrey Nikolaevich,
Doctor of Medical Sciences, Associate Professor, Lecturer at the 1st Department of Advanced Training Surgery, Military Medical Academy named after S.M. Kirov; Professor of the Department of Cardiovascular Surgery, North-Western State Medical University named after I.I. Mechnikov
ORCID ID: 0000-0003-4605-6678
E-mail: shishkevich50@mail.ru

Mikhaylov Sergey Sergeevich,
Doctor of Medical Sciences, Head of the Department of Endovascular Methods of Diagnosis and Treatment, 1st Department of Advanced Training Surgery, Military Medical Academy named after S.M. Kirov; Assistant at the Department of Cardiovascular Surgery, North-Western State Medical University named after I.I. Mechnikov
ORCID ID: 0000-0001-6093-2203
E-mail: mikhailov.vma@gmail.com

Kravchuk Vyacheslav Nikolaevich,
Doctor of Medical Sciences, Full Professor, Professor of the 1st Department of Advanced Training Surgery, Military Medical Academy named after S.M. Kirov; Head of the Department of Cardiovascular Surgery, North-Western State Medical University named after I.I. Mechnikov
ORCID ID: 0000-0002-6337-104X
E-mail: kravchuk9@yandex.ru

Khubulava Gennadiy Grigorievich,
Academician of the Russian Academy of Sciences, Doctor of Medical Sciences, Full Professor, Head of the 1 st Department of Advanced Training Surgery, Military Medical Academy named after S.M. Kirov
ORCID ID: 0000-0001-9093-8024
E-mail: as015@rambler.ru

Information about support in the form of grants, equipment, medications

The authors did not receive financial support from manufacturers of medicines and medical equipment

Conflicts of interest: No conflict

Address for correspondence:

Bessonov Evgeniy Yurievich
Endovascular Surgeon, Department of Endovascular Methods of Diagnosis and Treatment, Alexander Hospital

193312, Russian Federation, St. Petersburg, Solidarity Avenue, 4

Tel.: +7 (911) 1956808

Е-mail: ewgenijbessonov@yandex.ru

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