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Background — Percutaneous coronary intervention (PCI) in patients with acute coronary syndrome (ACS) should be performed in presence of objective evidence of myocardial ischemia. Our study investigated the appropriateness of PCI among ACS patients in Russia and explored clinical factors associated with PCI performance. Methods and results — Clinical information about 65,912 ACS patients (60.5% male, aged 63.2±13.8 years) enrolled in the 2010–2011 Russian ACS Registry was examined. ACCF 2012 criteria were used to assess the appropriateness of PCI. PCI was performed in 13.8% of patients included in the study. Among patients with performed PCI (ACS-PCI patients), it was appropriate in 68.9%. In patients refused from PCI (ACS-nonPCI patients), it would be appropriate in 57.9% patients. Main clinical factors related to PCI were age, male sex, prior PCI, ST-segment elevation on ECG, and accordance with any of ACCF 2012 appropriate use criteria. But these factors were attributable for ACS-PCI patients only. It was a low correlation between these clinical factors and refuse from PCI. Conclusions — It was shown that intervention was appropriate in the most patients with ACS received PCI. Among patients, refused from revascularization, PCI would be appropriate in more than half of them. We revealed that several clinical characteristics of ACS patients, including ACCF 2012 criteria, are fundamental for the decision to conduct PCI, but the negative decision was determined by other, non-clinical factors.
Kiselev AR, Popova YV, Posnenkova OM, Gridnev VI, Dovgalevsky PYa, Russian Registry of Acute Coronary Syndrome Investigators. Implementation of percutaneous coronary interventions in patients with acute coronary syndrome in Russia and clinical factors influencing decision making. Cor et Vasa 2014; 56(1): e1-e10.