Clinical role of the “symptom-balloon” time in endovascular treatment of acute coronary syndrome with ST segment elevation

Abstract

Aim. To investigate the clinical effectiveness of endovascular revascularization of the infarct-related coronary artery (IRCA) in regard to the “symptom-balloon” time, analyzing retrospective data on patients with acute coronary syndrome (ACS) and ST segment elevation (STE-ACS). Material and methods. The study included 164 patients with STE-ACS, who underwent selective coronary angiography (CAG) and transluminal balloon angioplasty (TLBAP) with coronary stenting. Based on the “symptom-balloon” time, all patients were divided into two groups. In Group I (n=78), the “symptom-balloon” time was <6 hours, while in Group II (n=86), it was 6–24 hours. Echocardiography (EchoCG) was performed at Day 1, 7, and 30. Results. The EchoCG data demonstrated a reduction in left ventricular (LV) systolic function. In Group I, LV systolic function significantly improved by Day 7: LV ejection fraction (EF) increased from 48,2% to 51,6% (p=0,0013). At Day 30, LV EF was 54,7% (p=0,001). In Group II, the increase in LV EF was not statistically significant (from 46,1% to 47,2%; p=0,2197).Conclusion. Urgent coronary revascularization in STE-ACS improved localLV contractility, due to the restriction of stunned myocardium areas. The speed of theLV contractility improvement after IRCA TLBAP/coronary stenting was strongly associated with the “symptom-balloon” time.

Keywords

• время «симптом-баллон»
• острый коронарный синдром
• транслюминальная баллонная ангиопластика со стентированием
• систолическая функция левого желудочка