Stenting versus Pharmacological Therapy in Treatment of Single Vessel Intermediate Culprit Lesion ..

In acute ST- segment elevation myocardial infarction (STEMI) patients, primary percutaneous coronary intervention (PCI) with stent implantation has been the preferred treatment. As compared to medical care alone, stent placement allows for more lumen gain and reduces the chance of re-occlusion of the infarct-related artery. The aim of this study was to see how efficient stenting of a single vessel intermediate culprit lesion stenosis was compared to pharmacological treatment alone in acute STEMI patients. Methods: A prospective comparative interventional case series was used in this analysis.It involved 60 patients with acute STEMI who were admitted to our University hospital's coronary care unit.

All patients underwent a thorough medical history, physical examination, 12-lead ECG , echocardiography, cardiac catheterization, and angiography (TIMI flow and corrected TIMI frame count (CTFC)).Patients with intermediate culprit lesions (40 70 percent ) single vessel stenosis were chosen.

Two groups of patients were formed:

Group A: 30 patients who, in addition to regular pharmacological therapy, had the culprit lesion stented.

30 patients in Group B were given pharmacological careand no stenting (in addition to normal pharmacological therapy, Glycoprotein II b/IIIa inhibitor).Significant adverse cardiac events (MACE) were recorded after a 12-month follow-up period (death, myocardial infarction, coronary re-vascularization, stroke and hospitalisation because of heart failure). The results showed that 63.3 percent of group A patients had full ST segment resolution compared to 30% of group B patients (P=0.034).

In terms of TIMI Flow, there was a statistically significant difference between groups A and B (P value=0.005). Slow quick blood flow (CTFC60) was reported in one patient (3.3%) in group A, while it was reported in five patients in group B. (16 percent ). In terms of CTFC, there was a statistically significant difference between the two classes (P=0.029). MACE were registered in one patient in group A versus four patients in group B at the 12-month follow-up (P value >0.05). Conclusion: Stent implantation was found to improve immediate efficacy and protection in acute STEMI patients with single vessel intermediate culprit lesion stenosis, as well as reduce MACE.

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