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Total versus staged versus functional revascularization in NSTEACS patients with multivessel disease

BACKGROUND: The optimal strategy for revascularization in patients with NSTEACS who had multivessel coronary artery disease. A lack of evidence exists about the role of complete coronary revascularization by PCI in patients with non-ST segment elevation acute coronary syndrome (NSTEACS). Till now, A...

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Autores principales: Elkady, Ahmed O., Abdelghany, Mohamed, Diab, Reda, Ezz, Ahmed, Elagha, Abdalla A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8236005/
https://www.ncbi.nlm.nih.gov/pubmed/34173899
http://dx.doi.org/10.1186/s43044-021-00179-0
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author Elkady, Ahmed O.
Abdelghany, Mohamed
Diab, Reda
Ezz, Ahmed
Elagha, Abdalla A.
author_facet Elkady, Ahmed O.
Abdelghany, Mohamed
Diab, Reda
Ezz, Ahmed
Elagha, Abdalla A.
author_sort Elkady, Ahmed O.
collection PubMed
description BACKGROUND: The optimal strategy for revascularization in patients with NSTEACS who had multivessel coronary artery disease. A lack of evidence exists about the role of complete coronary revascularization by PCI in patients with non-ST segment elevation acute coronary syndrome (NSTEACS). Till now, ACC/AHA and ESC guidelines are not clear regarding the optimal strategy for revascularization in NSTEACS patients with multivessel coronary artery disease. In this setting, identification of the culprit lesion by angiography only could be challenging. The objective is to compare the hospital and short-term (6 months) outcomes of 3 different coronary revascularization strategies in NSTEACS patients with and multivessel coronary artery disease. RESULTS: Our study was a prospective study that included 90 patients who presented with acute chest pain and were diagnosed with NSTEACS. The patients were divided into 3 groups according to the plan of management: total revascularization group (total group), staged revascularization group (staged group), and functional revascularization group using FFR (FFR group). We studied the effect of demographic data, risk factors, and angiographic and procedural criteria on hospital and short-term outcomes. No significant statistical difference was seen among the three groups regarding the hospital outcome (in-stent thrombosis, unstable angina, and renal impairment). Also, the short-term (after 6 months) outcome regarding myocardial infarction, hospitalization, stroke, and cardiac death did not differ significantly between the three groups. CONCLUSIONS: Considering NSTEACS patients with multivessel disease, different coronary revascularization strategies (total, staged, or FFR) are comparable regarding immediate and short-term (6 months) clinical follow-up. FFR can change the preplanned management, and less number of stents per patient is needed when FFR is utilized.
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spelling pubmed-82360052021-07-09 Total versus staged versus functional revascularization in NSTEACS patients with multivessel disease Elkady, Ahmed O. Abdelghany, Mohamed Diab, Reda Ezz, Ahmed Elagha, Abdalla A. Egypt Heart J Research BACKGROUND: The optimal strategy for revascularization in patients with NSTEACS who had multivessel coronary artery disease. A lack of evidence exists about the role of complete coronary revascularization by PCI in patients with non-ST segment elevation acute coronary syndrome (NSTEACS). Till now, ACC/AHA and ESC guidelines are not clear regarding the optimal strategy for revascularization in NSTEACS patients with multivessel coronary artery disease. In this setting, identification of the culprit lesion by angiography only could be challenging. The objective is to compare the hospital and short-term (6 months) outcomes of 3 different coronary revascularization strategies in NSTEACS patients with and multivessel coronary artery disease. RESULTS: Our study was a prospective study that included 90 patients who presented with acute chest pain and were diagnosed with NSTEACS. The patients were divided into 3 groups according to the plan of management: total revascularization group (total group), staged revascularization group (staged group), and functional revascularization group using FFR (FFR group). We studied the effect of demographic data, risk factors, and angiographic and procedural criteria on hospital and short-term outcomes. No significant statistical difference was seen among the three groups regarding the hospital outcome (in-stent thrombosis, unstable angina, and renal impairment). Also, the short-term (after 6 months) outcome regarding myocardial infarction, hospitalization, stroke, and cardiac death did not differ significantly between the three groups. CONCLUSIONS: Considering NSTEACS patients with multivessel disease, different coronary revascularization strategies (total, staged, or FFR) are comparable regarding immediate and short-term (6 months) clinical follow-up. FFR can change the preplanned management, and less number of stents per patient is needed when FFR is utilized. Springer Berlin Heidelberg 2021-06-26 /pmc/articles/PMC8236005/ /pubmed/34173899 http://dx.doi.org/10.1186/s43044-021-00179-0 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Research
Elkady, Ahmed O.
Abdelghany, Mohamed
Diab, Reda
Ezz, Ahmed
Elagha, Abdalla A.
Total versus staged versus functional revascularization in NSTEACS patients with multivessel disease
title Total versus staged versus functional revascularization in NSTEACS patients with multivessel disease
title_full Total versus staged versus functional revascularization in NSTEACS patients with multivessel disease
title_fullStr Total versus staged versus functional revascularization in NSTEACS patients with multivessel disease
title_full_unstemmed Total versus staged versus functional revascularization in NSTEACS patients with multivessel disease
title_short Total versus staged versus functional revascularization in NSTEACS patients with multivessel disease
title_sort total versus staged versus functional revascularization in nsteacs patients with multivessel disease
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8236005/
https://www.ncbi.nlm.nih.gov/pubmed/34173899
http://dx.doi.org/10.1186/s43044-021-00179-0
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