ẢNH HƯỞNG CỦA TÁI TƯỚI MÁU HOÀN TOÀN LÊN ĐAU NGỰC TÁI PHÁT Ở BỆNH NHÂN NHỒI MÁU CƠ TIM CẤP ST CHÊNH LÊN VỚI TỔN THƯƠNG NHIỀU NHÁNH MẠCH VÀNH

Abstract

Objective: This study aimed to assess the hospitalization rate for recurrent chest pain following complete versus incomplete revascularization in patients with ST-segment elevation myocardial infarction (STEMI) and multivessel disease. Subjects and methods: A prospective cohort study was conducted on STEMI patients undergoing revascularization procedures from April 2022 to June 2022 at the Interventional Cardiology and Cardiology Departments of Cho Ray Hospital. Results: The study included 105 patients (69.5% male, mean age 64.1 ± 11.5) with a high prevalence of cardiovascular risk factors, notably dyslipidemia (88.6%) and hypertension (73.3%). The complete revascularization group exhibited lower recurrence of chest pain requiring hospitalization at 1 month (6.1% vs. 9.8%) and 3 months (12.1% vs. 29.2%). Although statistical significance was not reached (p = 0.72 and 0.08), the Kaplan-Meier curve indicated a noticeable divergence in recurrence rates over time. Patients with incomplete revascularization, especially those with an untreated LAD branch, had a significantly higher risk of hospitalization due to chest pain compared to those untreated in other coronary branches (52.4% vs. 19.6%, HR = 2.23, 95% CI: 1.13–6.25; p = 0.026). Conclusion: The study suggests a trend toward a reduced risk of hospitalization for recurrent chest pain with complete revascularization in STEMI patients with multivessel disease. For patients not achieving complete revascularization, particularly when the LAD branch is untreated, the risk of rehospitalization due to recurrent chest pain is significantly elevated.