Clinical efficacy of coronary angioplasty of chronic occlusion in patients with previous Q-myocardial infarction

Objective: to evaluate the clinical effects of delayed reperfusion of chronically occluded IRA in patients after Q-myocardial infarction (Q-MI), in relation to the general and local contractility of left ventricular ejection fraction (LVEF). Material and Methods. The study included 200 patients with previous Q-MI. PCI for chronic occlusion of the IRA was performed in an average period of 1-2 months after the documented Q-MI. Complete clinical and instrumental examination of patients was performed before the PCI and after 12 months. Symptoms of angina, left ventricular ejection fraction, prevalence areas of hypo-and akinesia infarction and functional class of chronic heart failure have been evaluated. Results. Statistically significant reduction in the number of patients with symptoms of angina: 41 (20.5%) versus baseline 94 (47%), p <0,0001; significant improvement in myocardial contractile function —the number of patients with LV EF <4076% reduction (38%) to 32 (16%), p <0.0001 have been revealed. An increase in the frequency of functional classes of heart failure has not reached the statistical significance. According to the ultrasound investigation of hypo-and akinesia areas of infarction there was a statistically significant increase in the incidence of myocardial hypokinesis prevalence of 152 (76%) versus baseline 103 (51.5%), p <0.0001. Conclusions. The late recanalization of chronic occlusion (after 8 weeks post-MI) with the restoration of optimum antegrade blood flow improves left ventricular function and long-term prognosis reducing the risk of cardiovascular disorders during the period of the 12-month follow-up