title: [Percutaneous Coronary Intervention in Patients With Acute Myocardial Infarction With ST-Segment Elevation After Prehospital Thrombolysis].
abstract: OBJECTIVE
  to analyze results of percutaneous coronary intervention (PCI) in patients with acute ST- elevation myocardial infarction performed after prehospital thrombolysis in real clinical practice.
  
  
  METHODS
  In the period from 2008 to 2013 144 and 577 patients were subjected to PCI after prehospital thrombolysis with tenecteplase (pharmacoinvasive group - PhG) and primary PCI (PPCIG), respectively.
  
  
  RESULTS
  PhG compared with PPCIG contained younger patients (mean age 56.9+/-0.2 and 59.6+/-1.2 years, respectively; p=0.01), and higher portion of men (84.7 and 72.6%, respectively; p=0.003). Frequency of complete occlusion of infarct-related artery in PhG was lower (41.7 and 71.4%, respectively; p< 0.001). Time from onset of pain to administration of a thrombolytic drug was 80 (55; 172) min, PCI was performed in 270 (120; 540) min after thrombolysis. In PPCIG time from onset of symptoms to hospital admission was 120 (60; 230) min, "door-to-balloon" time - 86 (67; 115) min. There was no difference between groups in the composite outcome comprising death, recurrent infarction and stent thrombosis, as well as in frequency of bleeding complications at the puncture site. Rate of major cardiac complications during hospital stay was independently associated with elderly age (odds ratio [OR 1.05; 95% confidence interval [CI] 1.02 to 1.08), previous myocardial infarction (OR 2.21, 95% CI 1.18 to 4.18), and total occlusion of infarct-related artery (OR 4.08, 95%Cl 1.86 to 8.94). Pharmacoinvasive strategy was not associated with reduction of the incidence of major cardiac events (OR 1.25, 95%CI 0.60 to 2.60).
  
  
  CONCLUSIONS
  In settlements with PCI capable hospital primary PCI is clinically and economically justified.Key words: myocardial infarction; pharmacoinvasive strategy; primary percutaneous coronary intervention; prehospital thrombolysis.
authors.affiliation: 1Affiliate of the Cardiology Research Institute Cardiology Center, Tyumen, Russia; 2Central State Medical Academy, President Management Department RF, Moscow, Russia.
authors.forename: I S
authors.initials: IS
authors.lastname: Bessonov
authors.affiliation: 1Affiliate of the Cardiology Research Institute Cardiology Center, Tyumen, Russia; 2Central State Medical Academy, President Management Department RF, Moscow, Russia.
authors.forename: V A
authors.initials: VA
authors.lastname: Kuznetsov
authors.affiliation: 1Affiliate of the Cardiology Research Institute Cardiology Center, Tyumen, Russia; 2Central State Medical Academy, President Management Department RF, Moscow, Russia.
authors.forename: I P
authors.initials: IP
authors.lastname: Zyryanov
authors.affiliation: 1Affiliate of the Cardiology Research Institute Cardiology Center, Tyumen, Russia; 2Central State Medical Academy, President Management Department RF, Moscow, Russia.
authors.forename: N A
authors.initials: NA
authors.lastname: Musikhina
authors.affiliation: 1Affiliate of the Cardiology Research Institute Cardiology Center, Tyumen, Russia; 2Central State Medical Academy, President Management Department RF, Moscow, Russia.
authors.forename: S S
authors.initials: SS
authors.lastname: Sapozhnikov
authors.affiliation: 1Affiliate of the Cardiology Research Institute Cardiology Center, Tyumen, Russia; 2Central State Medical Academy, President Management Department RF, Moscow, Russia.
authors.forename: A G
authors.initials: AG
authors.lastname: Takkand
authors.affiliation: 1Affiliate of the Cardiology Research Institute Cardiology Center, Tyumen, Russia; 2Central State Medical Academy, President Management Department RF, Moscow, Russia.
authors.forename: D A
authors.initials: DA
authors.lastname: Zateyshchikov
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D001145:Arrhythmias, Cardiac; D005343:Fibrinolytic Agents; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology / Q000628:therapy*; D016017:Odds Ratio; D012307:Risk Factors; D000077785:Tenecteplase; D015912:Thrombolytic Therapy / Q000009:adverse effects; D013997:Time Factors; D010959:Tissue Plasminogen Activator
chemical_list: D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator; D000077785:Tenecteplase