Degree of coronary occlusions links to the patient clinical outcome: four cases of double culprits acute ST-segment elevation myocardial infarction

Background: Double coronary culprit lesions in ST-segment elevation myocardial infarction (STEMI) is uncommon. Despite successful primary percutaneous coronary intervention (PPCI) in all culprit lesions, the clinical outcome remains unfavorable and the possible factors for the outcome are not fully...

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Autores principales:	Ilham Uddin, Anindia Wardhani, Misbah Hari Cahyadi, Desy Ayu Puspitasari, Pipin Ardhianto, Udin Bahrudin, Yan Herry, Sodiqur Rifqi
Formato:	article
Lenguaje:	EN
Publicado:	Diponegoro University 2021
Materias:	st-segment elevation myocardial infarction double coronary artery culprits clinical out-come degree of coro-nary occlusion Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/75c1f6911f1a430d919c845f4e321afc
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spelling	oai:doaj.org-article:75c1f6911f1a430d919c845f4e321afc2021-11-05T16:47:43ZDegree of coronary occlusions links to the patient clinical outcome: four cases of double culprits acute ST-segment elevation myocardial infarction2503-217810.14710/jbtr.v7i1.10693https://doaj.org/article/75c1f6911f1a430d919c845f4e321afc2021-04-01T00:00:00Zhttps://ejournal2.undip.ac.id/index.php/jbtr/article/view/10693https://doaj.org/toc/2503-2178Background: Double coronary culprit lesions in ST-segment elevation myocardial infarction (STEMI) is uncommon. Despite successful primary percutaneous coronary intervention (PPCI) in all culprit lesions, the clinical outcome remains unfavorable and the possible factors for the outcome are not fully understood. Cases Presentation: We reported four cases of double culprit lesions STEMI underwent PPCI. Patient A, a 62 y.o. male with extensive anterior-inferior STEMI, had total occlusion (TO) at both proximal left anterior descending (LAD) and mid right coronary artery (RCA). Patient B, a 42 y.o. male with extensive anterior-inferior STEMI, had subtotal occlusion (STO) at proximal RCA and TO at proximal LAD. Both of them had RBBB ECG pattern. Patient C, a 67 y.o. male with inferior STEMI had 90% thrombus occlusion at proximal–mid LAD and TO at proximal RCA. Patient D, a 65 y.o. male with anteroseptal STEMI, had STO at proximal LAD and 80% thrombus occlusion at mid left circumflex. The cardiomyocyte infarction biomarkers increased in all patients. Although all of them underwent successful PPCI in all of culprit lesions, they suffered from acute heart failure and two of them experienced recurrent ventricular arrhythmia episodes. One of them (patient A) died two days post PPCI. He was only patient who suffering from total occlusion in LAD and RCA with TIMI thrombus 5 and experienced a total atrioventricular block post-PPCI. Conclusion: STEMI with coronary double culprits have severe clinical outcome, regardless of the successful PCI. The degree of coronary occlusions might be linked to the patient clinical outcome.Ilham UddinAnindia WardhaniMisbah Hari CahyadiDesy Ayu PuspitasariPipin ArdhiantoUdin BahrudinYan HerrySodiqur RifqiDiponegoro Universityarticlest-segment elevation myocardial infarctiondouble coronary artery culpritsclinical out-comedegree of coro-nary occlusionMedicine (General)R5-920ENJournal of Biomedicine and Translational Research, Vol 7, Iss 1, Pp 30-37 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	st-segment elevation myocardial infarction double coronary artery culprits clinical out-come degree of coro-nary occlusion Medicine (General) R5-920
spellingShingle	st-segment elevation myocardial infarction double coronary artery culprits clinical out-come degree of coro-nary occlusion Medicine (General) R5-920 Ilham Uddin Anindia Wardhani Misbah Hari Cahyadi Desy Ayu Puspitasari Pipin Ardhianto Udin Bahrudin Yan Herry Sodiqur Rifqi Degree of coronary occlusions links to the patient clinical outcome: four cases of double culprits acute ST-segment elevation myocardial infarction
description	Background: Double coronary culprit lesions in ST-segment elevation myocardial infarction (STEMI) is uncommon. Despite successful primary percutaneous coronary intervention (PPCI) in all culprit lesions, the clinical outcome remains unfavorable and the possible factors for the outcome are not fully understood. Cases Presentation: We reported four cases of double culprit lesions STEMI underwent PPCI. Patient A, a 62 y.o. male with extensive anterior-inferior STEMI, had total occlusion (TO) at both proximal left anterior descending (LAD) and mid right coronary artery (RCA). Patient B, a 42 y.o. male with extensive anterior-inferior STEMI, had subtotal occlusion (STO) at proximal RCA and TO at proximal LAD. Both of them had RBBB ECG pattern. Patient C, a 67 y.o. male with inferior STEMI had 90% thrombus occlusion at proximal–mid LAD and TO at proximal RCA. Patient D, a 65 y.o. male with anteroseptal STEMI, had STO at proximal LAD and 80% thrombus occlusion at mid left circumflex. The cardiomyocyte infarction biomarkers increased in all patients. Although all of them underwent successful PPCI in all of culprit lesions, they suffered from acute heart failure and two of them experienced recurrent ventricular arrhythmia episodes. One of them (patient A) died two days post PPCI. He was only patient who suffering from total occlusion in LAD and RCA with TIMI thrombus 5 and experienced a total atrioventricular block post-PPCI. Conclusion: STEMI with coronary double culprits have severe clinical outcome, regardless of the successful PCI. The degree of coronary occlusions might be linked to the patient clinical outcome.
format	article
author	Ilham Uddin Anindia Wardhani Misbah Hari Cahyadi Desy Ayu Puspitasari Pipin Ardhianto Udin Bahrudin Yan Herry Sodiqur Rifqi
author_facet	Ilham Uddin Anindia Wardhani Misbah Hari Cahyadi Desy Ayu Puspitasari Pipin Ardhianto Udin Bahrudin Yan Herry Sodiqur Rifqi
author_sort	Ilham Uddin
title	Degree of coronary occlusions links to the patient clinical outcome: four cases of double culprits acute ST-segment elevation myocardial infarction
title_short	Degree of coronary occlusions links to the patient clinical outcome: four cases of double culprits acute ST-segment elevation myocardial infarction
title_full	Degree of coronary occlusions links to the patient clinical outcome: four cases of double culprits acute ST-segment elevation myocardial infarction
title_fullStr	Degree of coronary occlusions links to the patient clinical outcome: four cases of double culprits acute ST-segment elevation myocardial infarction
title_full_unstemmed	Degree of coronary occlusions links to the patient clinical outcome: four cases of double culprits acute ST-segment elevation myocardial infarction
title_sort	degree of coronary occlusions links to the patient clinical outcome: four cases of double culprits acute st-segment elevation myocardial infarction
publisher	Diponegoro University
publishDate	2021
url	https://doaj.org/article/75c1f6911f1a430d919c845f4e321afc
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Degree of coronary occlusions links to the patient clinical outcome: four cases of double culprits acute ST-segment elevation myocardial infarction

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