Characteristics of atherosclerotic coronary lesions in young and middle-aged diabetic patients with acute myocardial infarction
This article investigates the characteristics of atherosclerotic coronary lesions and reperfusion strategy by percutaneous coronary intervention (PCI) coronary artery revascularisation in relation to prognosis in a population of young and middle-aged diabetic patients with acute myocardial infarction (AMI). AMI patients were examined by determining biomarkers and performing echocardiography (Echo) on the first day of AMI after PCI with infarct-related coronary artery stenting; Echo and NTproBNP determination were repeated 12 months later. Multivessel lesions were found to be 41 % and 59 % of DM patients had a single coronary artery lesion. Multivessel lesions among 35 DM patients with anterior AMI were reported in 18 (51 %). In non-anterior AMI, multivessel lesions were observed in 13 of 41 (31 %) DM patients. Stenosis of the proximal segment of the right coronary artery (RCA) was found to be more common in patients with multivessel AMI. In DM patients with anterior AMI with multivessel disease, the prevalence of midline segment stenosis is second only to stenosis in the proximal segment of the RCA. Adverse prognosis in the long term among young and middle-aged AMI patients with DM was more common than in patients without DM. The choice of coronary revascularisation strategy in patients with multivessel AMI is driven by the need to open all arteries with stenosis equal to or greater than 75 %, especially the distal segment of the left coronary artery (LСА).
Wang Zh, Makeeva T.I. Characteristics of atherosclerotic coronary lesions in young and middle-aged diabetic patients with acute myocardial infarction. Challenges in Modern Medicine, 44 (4): 383–403 (in Russian). DOI: 10.52575/2687-0940-2021-44-4-383-403.
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