PMID- 19537582
OWN - NLM
STAT- MEDLINE
DCOM- 20090914
LR  - 20161125
IS  - 0040-3660 (Print)
IS  - 0040-3660 (Linking)
VI  - 81
IP  - 5
DP  - 2009
TI  - [Spontaneous reperfusion of the infarct-related artery in patients with ST 
      elevated myocardial infarction].
PG  - 20-9
AB  - AIM: To characterize a clinical course of ST elevation myocardial infarction 
      (STEMI) and spontaneous reperfusion of the coronary arteries (SR) as well as in 
      patients after reperfusion thrombolytic therapy (TLT) and/or transluminal balloon 
      coronary angioplasty (TBCA); to compare effectiveness of different approaches to 
      treatment of SR patients: conservative--early medication and active--TBCA on the 
      first postmyocardial 24 hours. MATERIAL AND METHODS: We studied 479 patients 
      admitted to hospital not later than 6 hours since STEMI onset and either having 
      SR (n = 49) or treated using active methods of coronary circulation 
      restoration--prehospital thrombolysis (n = 127), thrombolysis after 
      hospitalization (n = 127), primary TBCA (n = 60) and TBCA after initiation of TLT 
      (n = 116). We made a more detailed analysis on the sample of 149 SR patients. 
      RESULTS: SR was diagnosed in 10.2% cases with STEMI and occurred much earlier 
      than recovery of coronary circulation due to TLT and/or TBCA. Patients with SR 
      developed Q-MI, right ventricular infarction, cardiac failure and 
      atrioventricular block less frequently. They had the lowest peak activity of 
      creatin phosphokinase and a higher left ventricular ejection fraction versus 
      patients without SR (50.7 +/- 6.8 and 45.4 +/- 6.6%, respectively; p < 0.05). As 
      shown by coronaroangiography, SR patients had no "no reflow" phenomenon (0% and 
      17%, respectively). Active policy of SR patients treatment had no significant 
      advantages over conservative treatment. CONCLUSION: Early SR had more favourable 
      course of MI, less mass of the affected myocardium and better contractile 
      function of the left ventricle. The conservative policy of STEMI treatment in the 
      presence of SR is more effective than the active one if a due control over the 
      patients' condition is provided.
FAU - Ruda, M Ia
AU  - Ruda MIa
FAU - Kuz'min, A I
AU  - Kuz'min AI
FAU - Merkulova, I N
AU  - Merkulova IN
FAU - Samko, A N
AU  - Samko AN
FAU - Merkulov, E V
AU  - Merkulov EV
FAU - Sozykin, A V
AU  - Sozykin AV
FAU - Akasheva, D U
AU  - Akasheva DU
LA  - rus
PT  - Clinical Trial
PT  - Journal Article
PL  - Russia (Federation)
TA  - Ter Arkh
JT  - Terapevticheskii arkhiv
JID - 2984818R
RN  - 0 (Fibrinolytic Agents)
SB  - IM
MH  - *Angioplasty, Balloon, Coronary
MH  - Coronary Angiography
MH  - *Coronary Circulation/physiology
MH  - Coronary Vessels/*diagnostic imaging
MH  - Electrocardiography
MH  - Female
MH  - Fibrinolytic Agents/*therapeutic use
MH  - Hemodynamics/physiology
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/diagnosis/diagnostic imaging/physiopathology/*therapy
MH  - Recurrence
MH  - Remission, Spontaneous
MH  - Time Factors
MH  - Ultrasonography
EDAT- 2009/06/23 09:00
MHDA- 2009/09/15 06:00
CRDT- 2009/06/23 09:00
PHST- 2009/06/23 09:00 [entrez]
PHST- 2009/06/23 09:00 [pubmed]
PHST- 2009/09/15 06:00 [medline]
PST - ppublish
SO  - Ter Arkh. 2009;81(5):20-9.