ENDOVASCULAR TREATMENT OF PATIENTS WITH ACUTE CORONARY SYNDROME WITHOUT ST-SEGMENT ELEVATION AND MULTIVESSEL DISEASES: SELECTING THE BEST STRATEGY REVASCULARIZATION
346 patients were enrolled and initially randomized into 3 groups. In the I group included 100 patients who had complete myocardial revascularization was performed at the initial PCI. In the II group included 124 patients who complete myocardial revascularization was performed during initial hospitalization, and in the III group - 122 patients who complete revascularization was performed at different times after the initial hospitalization. Inclusion criteria: patients ACS without elevation ST with multivessel coronary disease (risk SYNTAX score = 23-32); high and medium risk for the GRACE scale; in the absence of a history of myocardial revascularization. Long-term results of treatment were evaluated in 192 patients. After 12 months, patients in group III was significantly more likely to have greater cardio - vascular complications and re-interventions on the target vessel. It was found that the performance of the complete myocardial revascularization within 30 days from the date of diagnosed acute coronary syndrome, a negative impact on the prognosis of the disease (r = 0,58, p < 0,05). Risk factors adversely affecting the prognosis of patients ACS without elevation ST with multivessel disease include subtotal stenosis in unsimptom arteries, failure class III Killip circulation, myocardial infarction, high risk on the scale of the GRACE, lesion length in nesimptomnyh arteries more than 20mm, diabetes, the degree of risk on a scale SYNTAXscore> 25, overweight / obesity, and high cholesterol> 6.5 mmol / l.