الفهرس | Only 14 pages are availabe for public view |
Abstract Background: Primary PCI, defined as percutaneous catheter intervention in the setting of STEMI without previous fibrinolysis, is the preferred reperfusion strategy. It has replaced fibrinolysis in patients with STEMI. The term re-infarction is used clinically for an acute MI that occurs within 28 days of an incident or recurrent MI. Although rates of re-infarction are lower after reperfusion by primary percutaneous coronary intervention (PCI) than after fibrinolytic therapy, re-infarction remains a major cause of morbidity and mortality. Objective: The present study aimed to compare clinical background, in hospital prognosis, determinants of in hospital outcome in reinfarction after PCI patients with those of first AMI and impact of primary PCI in both groups. Patients and methods: The study included 60 patients. They were divided into two groups: Group1: Included 30 patients presented with first time STEMI and managed with primary PCI. group 2: Included 30 patients managed with PCI after presentation with reinfarction after primary PCI, then followed up in addition to the thorough history taking, clinical examination, ECG, Echocardiography, coronary angiography and primary PCI and in hospital follow up of patients for assessment of outcome of PCI in both patients group. Comparison between the two groups on the basis of outcome were done. Results: Our study also declared the significant impact of reinfarction on the outcome of PCI as there was significant difference between both groups as regards adverse outcome as group 2 showed more adverse outcomes. Conclusion: We found that outcome of PCI after reinfarction had poor outcome in comparison with PCI in patients with STEMI for the first time. The risk of reinfarction may be reduced by optimal coronary revascularization and aggressive post-PCI treatment with dual antiplatelet therapy and strict secondary prevention measures. Key words: 1- ST elevation myocardial infarction 2- reinfarction 3- primary percutaneous coronary intervention. |