Objective: to evaluate the clinical effects of delayed reperfusion of chronically occluded IRA in patients after Q-myocardial infarction (Q-MI), in relation to the general and local contractility of left ventricular ejection fraction (LVEF). Material and Methods. The study included 200 patients with previous Q-MI. PCI for chronic occlusion of the IRA was performed in an average period of 1-2 months after the documented Q-MI. Complete clinical and instrumental examination of patients was performed before the PCI and after 12 months. Symptoms of angina, left ventricular ejection fraction, prevalence areas of hypo-and akinesia infarction and functional class of chronic heart failure have been evaluated. Results. Statistically significant reduction in the number of patients with symptoms of angina: 41 (20.5%) versus baseline 94 (47%), p <0,0001; significant improvement in myocardial contractile function —the number of patients with LV EF <4076% reduction (38%) to 32 (16%), p <0.0001 have been revealed. An increase in the frequency of functional classes of heart failure has not reached the statistical significance. According to the ultrasound investigation of hypo-and akinesia areas of infarction there was a statistically significant increase in the incidence of myocardial hypokinesis prevalence of 152 (76%) versus baseline 103 (51.5%), p <0.0001. Conclusions. The late recanalization of chronic occlusion (after 8 weeks post-MI) with the restoration of optimum antegrade blood flow improves left ventricular function and long-term prognosis reducing the risk of cardiovascular disorders during the period of the 12-month follow-up.
Glukhov Е.А., . Baratova К.Yu, Shitikov I.V., Titkov l.V., Oleynik A.О., Ruzanov I.S., Samitin V.V., Sorokina E.N. Clinical efficacy of coronary angioplasty of chronic occlusion in patients with previous Q-myocardial infarction // Saratov Journal of Medical Scientific Research, Vol. 9, Issue 4, 2013, pp. 668-673

Goal: to investigate angiographic and clinical efficacy of percutaneous coronary interventions (PCI) on chronic total coronary occlusions (СТО) in patients with angina of low functional classes (FC) in direct and long-term period, comparatively to conservative medical treatment. Materials: 56 patients with СТО were included. Standard medical treatment was provided to all of them, everybody suffered angina FC 1-2. Left ventricle ejection fraction (LV EF) was 54±3%. 36 patients of group I underwent PCI of СТО 20 patients of group II were given conservative medical treatment. The follow-up period was 12 months. Results. In 30 patients of group I 36 attempts of PCI were angiographically and clinically successful -the absence of anginal symptoms and objective signs of myocardial ischemia. In the long-term period 21 patients of 30 had clinical success. LV EF increased to 57±4%. Long-term clinical success had 17 patients of group II, 5 patients had the decrement of angina FC by 1, 12 had initial clinical results. LV EFaccountes53,9±2,4%. There was no difference in the frequency of major adverse cardiac events between the groups. Conclusions: PCI of СТО in patients with angina of low FC improves clinical status in direct and long-term period. When isolated, angiographically unfavorable form of СТО is diagnosed, conservative treatment with effective medication in case of angina of low FC is used
Ruzanov I.S., Shitikov I.V., Titkov I.V., Razborova I.В., Sanbaev A.K., Zhuravel M.S., Oleynik A.O. Clinical efficacy of chronic total coronary occlusions recanalization in patients with angina of low functional classes // Saratov Journal of Medical Scientific Research, Vol. 8, Issue 1, 2012, pp. 63-67