Treatment of a cohort of patients with acute myocardial infarction and ST-segment elevation.

Abstract:

BACKGROUND:Although thrombolysis and primary CTA are well-established procedures, they are not administered in a large proportion of the patients with STEMI who arrive to the emergency rooms. OBJECTIVE:Describe initial and final the results in a cohort of STEMI patients METHODS:The study included, from hospital admission to the discharge, 158 patients diagnosed with STEMI, from a total of 351 patients with ACS admitted to hospitals in Campos dos Goytacazes, RJ, Brazil, between 2004 and 2006. RESULTS:Of the 158 patients with STEMI, 67.7% arrived to the hospital within 180 minutes, 81.3% within 360 minutes, and 8.4% after twelve hours from the symptoms. Cinecoronariographic studies (148) were performed (93,7%). Lesions of over 70% were observed in 266 artery territories. The initial treatment was CTA in 41 (26%), thrombolytics in 50 (32%), 80% of success. Clinical treatment in 67 (42%). Approximately 35% of the patients should have undergone thrombolysis, but they didn't. During the final treatment, 93 CTAs were performed: 89 with angiographic success (95.7%), bleeding 2 (2.2%), subacute occlusion 2 (2.2%), trunk dissection 1 (1.1%), pseudoaneurism 1 (1.1%). No deaths during angioplasty; during evolution, there were two deaths (2.1%). Twelve patients underwent myocardial revascularization surgery (MRS), while 53 underwent clinical treatment, with 11 deaths (20.7%). Global lethality was 9.5%, considering the three types of treatment. CONCLUSIONS:Patients were suitable for reperfusion, but one third of them did not have the procedure. Two deaths during evolution. The most predominant treatment was CTA, with low morbidity. Low global lethality.

journal_name

Arq Bras Cardiol

authors

Soares Jda S,Souza NR,Nogueira Filho J,Cunha CC,Ribeiro GS,Peixoto RS,Soares CE,Soares LC,Reis AF,Faria CA

doi

10.1590/s0066-782x2009000600009

subject

Has Abstract

pub_date

2009-06-01 00:00:00

pages

430-6, 448-55, 464-71

issue

6

eissn

0066-782X

issn

1678-4170

pii

S0066-782X2009000600009

journal_volume

92

pub_type

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