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( Irina Urvantseva ),( Konstantin Nikolaev ),( Mikhail Voevoda ),( Alevtina Nikolaeva ) 대한내과학회 2014 대한내과학회 추계학술발표논문집 Vol.2014 No.1
Background: SYNTAX score (SS) is an effective angiographic predictor of clinical outcomes in patients with multivessel coronary artery disease undergoing percutaneous coronary intervention, but the associations between high SS and short-term outcome in patients treated with primary percutaneous coronary intervention (PCI) for acute ST-segment elevation myocardial infarction (STEMI) have not been studied. The aim of this study was to evaluate associations of the severity of coronary artery disease according to SYNTAX score with short-term outcome and clinical characteristics in patients treated with PCI for acute STEMI. Methods: A total of 330 patients (274 male и 56 females, mean age 53.6±8.9 years) with acute STEMI who underwent primary PCI were stratifi ed into the 3 groups. For SS the following distribution was used: low (=22, N = 216), medium (23-32, N = 66), high score (>32, N = 48). All in-hospital clinical outcomes were estimated in these patients. Results: During the short-term observation in hospital cardiovascular mortality was higher in groups of high and medium SS in compared with group of low SS (18.8%, 12.1% and 1.4%, respectively, p<0.01). Besides that the no-refl ow phenomenon, stent thrombosis, pulmonary edema, pleural effusion, acute left ventricular aneurysm, recurrent myocardial infarction and bleeding were signifi cantly more frequent among the patients in high SS group (p<0.05). Multivariate binary logistic regression analyses demonstrated that SS is an independent determinant for pleural effusion (95 % confi dence interval (CI), 1.019-1.082; p=0.002), no-refl ow phenomenon (95 % CI, 1.008- 1.089; p=0.018), pulmonary edema (95 % CI, 1.027-1.090; p<0.001) and acute left ventricular aneurysm (95 % CI, 1.015-1.092; p=0.006). Conclusions: The SS is useful index to predict the risk of short-term adverse clinical events during hospitalization in patients with acute STEMI undergoing PCI.