SO SÁNH ĐẶC ĐIỂM BỆNH NHÂN NHỒI MÁU CƠ TIM CẤP ST CHÊNH LÊN VỚI TỔN THƯƠNG NHIỀU NHÁNH MẠCH VÀNH ĐƯỢC TÁI TƯỚI MÁU HOÀN TOÀN VÀ KHÔNG HOÀN TOÀN

Abstract

Background: Patients with ST-elevation myocardial infarction (STEMI) undergoing coronary angiography with multivessel coronary artery injury face a challenging prognosis. However, the rates of complete reperfusion vary across studies, influenced by factors such as timing and regional disparities. Objectives: To compare clinical and paraclinical features among patients with STEMI and multivessel coronary artery disease treated with either complete or incomplete revascularization. Materials and methods: This cross-sectional, prospective, descriptive study with longitudinal follow-up involved 105 patients with ST-elevation acute myocardial infarction who underwent primary percutaneous coronary revascularization from April 2022 to June 2022 at the Department of Interventional Cardiology and the Department of Cardiovascular Internal Medicine, Cho Ray Hospital. Results: The average age was 64.1 ± 11.5 years, with a male/female ratio of 2.28/1. The highest prevalence of cardiovascular risk factors was dyslipidemia (88.6%) and hypertension (73.3%). Inferior myocardial infarction (42.9%) was most common, followed by anterior wall infarction (37.1%), lateral wall infarction (13.3%), and large anterior infarct (6.7%). Common complications included acute pulmonary edema (17.1%) and third-degree atrioventricular block (12.3%). The most frequent culprit coronary artery branch was LAD (45.7%), followed by RCA (41.9%), LCx (11.3%), and LMCA (0.9%). Receiving coronary intervention < 12 hours after chest pain onset accounted for 67.6%, 12 to 24 hours for 26.7%, and after 24 hours for 5.6%. The rate of patients receiving complete reperfusion was 31.4%. No significant differences were observed in clinical (age, gender, blood pressure, heart rate, time from onset to emergency intervention, cardiovascular risk factors)  and paraclinical characteristics (HbA1C, Creatinine, hs-troponin I, LVEF, injury characteristics)  between the complete and incomplete reperfusion groups. Conclusions: These findings suggest that while a substantial proportion of patients received incomplete reperfusion, clinical and paraclinical characteristics did not significantly differ between those with complete and incomplete revascularization. Further research is warranted to explore the impact of revascularization strategies on long-term outcomes in this patient population.