Attestation committee
Accreditation committee
Expert committee
Dispositions, instructions
Normative acts
MANPOWER TRAINING
Nomenclature
Institutions
Scientific councils
Seminars
Theses		 Scientific advisers
Scientists
Doctoral students
Postdoctoral students
CNAA logo

 română | русский | english


FEATURES OF INTERVENTIONAL TREATMENT OF ACUTE MYOCARDIAL INFARCTION WITHOUT ST SEGMENT ELEVATION


Author: Surev Artiom
Degree:doctor of medicine
Speciality: 14.00.06 - Cardiology and Reumatology
Year:2022
Scientific advisers: Lucia Ciobanu
doctor habilitat, associate professor (docent)
Mihail Ciocanu
doctor habilitat, professor, Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova
Institution: Medical-Sanitary Public Institution Institute of Cardiology

Status

The thesis was presented on the 22 February, 2022
Approved by NCAA on the 1 July, 2022

Abstract

Adobe PDF document – 1.18 Mb / in romanian
Adobe PDF document – 1.15 Mb / in english

Thesis

CZU 616.127-005.8-089.819.1(043.2)

Adobe PDF document 3.20 Mb / in romanian
149 pages

Summary

The scientific novelty and originality: The present study provided additional evidence that destabilized coronary atherosclerotic plaque requires a different interventional approach at each stage of its pathogenesis. Both the approach timing and the used technique during the intervention are important. There were elucidated the factors influencing the prognosis of patients with acute myocardial infarction without ST-segment elevation classified in the intermediate and minor risk groups who underwent coronary angioplasty.

The theoretical importance. There were studied: the coronary arteries anatomy, atherosclerotic plaque structure, the degree of coronary lesion, the intracoronary physiology in patients with acute myocardial infarction without ST-segment elevation. The techniques used in the interventional approach of these patients were analyzed. It was compared the effectiveness of certain interventional techniques for approaching the ulcerated plaque by angiographic assessment of the distal coronary flow at the end of the intervention. It was proven the impact of distal embolization during stenting and unstable platelets with thrombotic component related to the recovery of the affected myocardium and the remodeling of the left ventricle in the medium term. There were studied the peculiarities of the left ventricular systolic function after percutaneous myocardial revascularization in patients with type 2 diabetes mellitus who have developed acute myocardial infarction without ST-segment elevation and are part of the intermediate risk group.

The applicable value of the work. It was developed a strategies for a special clinical conditions, such as acute myocardial infarction without elevation of the ST segment, with intermediate and minor risk, in order to optimally manage by cardiologists these large groups of patients. The optimal “time window” for myocardial revascularization was identified for these patients. It was stipulated a recommendations on the techniques used in the interventional approach to vulnerable plaque. The importance of diagnosing diabetes mellitus, monitoring and adequate correcting of blood glucose in patients with acute myocardial infarction without elevating the ST segment, who are exposed to percutaneous myocardial revascularization, has been considered.

Practical implementation. The materials obtained during the research were applied in the daily activity of the Department of Interventional Cardiology of "Institute of Cardiology" and the University Clinic of Interventional Cardiology, in courses at the Department of Cardiology, Department of Internal Diseases of the State University of Medicine and Pharmacy “Nicolae Testemițanu”. To note that the eese4ntial concepts was used in the elaboration of the 2017 National Clinical Protocol “Acute myocardial infarction”.