An observational study on the timing of appearance of coronary collaterals during acute ST elevation myocardial infarction (STEMI)

摘要

Background: Percutaneous coronary intervention (PCI) isa widely performed technique for coronary revascularization.Womenhave different risk factors, clinical and angiographic profileand in-hospital outcomes compared with men. This study intendedto elaborate clinical and angiographic profile and in-hospital outcomesin women undergoing elective PCI at our hospital.Materials and methods: This was a retrospective study conductedover 2 year period between February 2015 and February2017. This study included all women who underwent elective PCIat our hospital during the study period. Data includes the presenceof risk factors, clinical presentation, left ventricular functionand presence of complications, angiographic profile and in-hospitaloutcomes were analysed.Results: A total of 228 patients were included in the study, mostof them being in 41-60 years age group (59.6%). Diabetes mellitusand obesity were the most common risk factors being 66% and44% respectively followed by dyslipidemia (40%). Most commonpresentation was ST elevated myocardial infarction (STEMI) (49%).20% of patients presented with unstable angina and 20% patientswith Non-ST segment elevated myocardial infarction and 20% werepresented with acute coronary syndrome. 2D echocardiographyshowed regional wall motion abnormality in 65% of patients, leftventricular (LV) ejection fraction was good in over 50.8% of patients,mild LV dysfunction in over 24.5% of patients, moderate LV dysfunctionin 16% of patients. Only 1% of women who underwentelective PCI had severe LV dysfunction. Moderate mitral regurgitationwas present in 8% of patients. Coronary angiography revealeddouble vessel disease in 108 (47%) of patients and single vessel diseasein 39% of women who underwent elective PCI. Triple vesseldisease was present in only 12% of women. 4 out of 228 womenhad graft disease and 5 patients had in-stent restenosis. Left anteriordescending artery was most commonly affected vessel (43% oflesions), followed by right coronary artery (25%) and then left circumflexcoronary artery (18.6%). Drug eluting stents were deployedin 95% of the lesions. Women with diabetes mellitus and type Clesions were stented with second generation drug eluting stentsmost often and in few cases bioabsorbable stents were used. Total20% of patients died in hospital after the procedure.