ST-yükselmeli miyokart enfarktüsü ile başvuran hastaların transfer parametrelerinin değerlendirilmesi
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Dosyalar
Tarih
2016
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Dergi ISSN
Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Akut koroner sendrom (AKS), ciddi morbidite ve mor-talite ile seyreden yaygın bir hastalıktır. Hızlı damar reper-füzyonu, AKS alt tipi olan ST-yükselmeli miyokart enfarktüsü (STYME) tedavisinin en önemli aşamasıdır. Sonuçların ba-şarısı sadece merkezin deneyimine değil, reperfüzyonun ne kadar kısa sürede sağlandığına da bağlıdır. Çalışmamızda merkezimize başvuran STYME'li hastaların transfer paramet-releri değerlendirildi.Yöntemler:Çalışmamıza Ocak 2011-Mart 2013 tarihleri ara-sında, STYME nedeniyle primer perkütan koroner girişim (PKG) uygulanan ardışık 200 hasta (160 erkek, 40 kadın) da-hil edildi. Hastaların semptom başlangıcından ilk damar açıcı tedaviye kadar olan transfer parametreleri, klinik özellikleri ve laboratuvar değerleri kaydedildi.Bulgular:Hastaların 36'sının ilk hastane başvurusunu 112 Acil Servis ambulansı ile yaptığı, 70 hastanın ilk olarak PKG yapılamayan bir merkeze başvurduğu ve bu hastala-rın merkezimize transfer süresinin ortalama 73.912.5 da-kika (dk) olduğu tespit edildi. Ağrı-ilk tıbbi temas süresinin medyan 105 (dağılım, 5-600) dk, ilk tıbbi temas-balon sü-resinin 115.5 (dağılım, 20-414) dk olduğu görüldü. Kadın-larda toplam ağrı-balon süresi erkeklere göre anlamlı olarak daha yüksekti (sırasıyla 246 [70-840]dk ve 195 [45-684] dk; p0.032). Ayrıca ilk tıbbi teması 112 Acil Servis sistemi ile sağlayan hastalarda ağrı balon süresi, kendi imkanları ile acil başvuru yapan hastalara göre istatiksel olarak anlamlı düzeyde daha düşük tespit edildi (sırasıyla 185 [45-439] dk ve 248 [65-840] dk; p0.017).Sonuç:Çalışmamızda hastanemiz kapı-balon süresinin Avru-pa Kardiyoloji Derneği ve Amerikan Kardiyoloji Koleji STEME kılavuzu hedefleri ile uyumlu olduğu, ilk tıbbi temas-balon sü-resinin güncel kılavuz önerilerinin üzerinde olduğu saptandı
Objective: Acute coronary syndrom (ACS) is a common dis- ease that causes severe morbidity and mortality. The most im- portant aspect of ST-elevation myocardial infarction (STEMI) as a subgroup of ACS treatment is the rapid reperfusion of ar- teries. Successful results depend not only on the experience of the center but also on the rapidity in which reperfusion is achieved. In our study, the transfer parameters were evaluat- ed in patients who were admitted to our hospital with STEMI. Methods: Two hundred consecutive patients (160 males, 40 females) who underwent primary percutaneous coronary in- tervention (PCI) for acute STEMI between January 2011 and March 2013 were included in our study. Transfer parameters of symptom-to-reperfusion treatment, clinical characteristics, and laboratory parameters were recorded. Results: Thirty-six patients were admitted to our hospital with ambulances; 70 patients were admitted to centers without PCI capability, with a mean transfer time to our hospital of 73.9±12.5 min. Median pain-to-first medical contact time was 105 min (range: 5-600 min), and average first medical con- tact-to-balloon time was 115.5 min (range: 20-414 min). Total pain-to-balloon time in females was significantly higher than males (246 min [range: 70-840 min], 195 min [range: 45-684 min], respectively, p0.032). Mean pain-to-balloon time was significantly lower in patients delivered to the hospital by am- bulance than in patients admitted to emergency departments independently (185 min [range: 45-439 min], 248 min [range: 65-840 min], respectively, p0.017). Conclusion: In this study, our hospital door-to-balloon time was found compatible with the target specified in the European So- ciety of Cardiology and American College of Cardiology STEMI guidelines; however, first medical contact-to-balloon time was found to be above that advised by the current guidelines
Objective: Acute coronary syndrom (ACS) is a common dis- ease that causes severe morbidity and mortality. The most im- portant aspect of ST-elevation myocardial infarction (STEMI) as a subgroup of ACS treatment is the rapid reperfusion of ar- teries. Successful results depend not only on the experience of the center but also on the rapidity in which reperfusion is achieved. In our study, the transfer parameters were evaluat- ed in patients who were admitted to our hospital with STEMI. Methods: Two hundred consecutive patients (160 males, 40 females) who underwent primary percutaneous coronary in- tervention (PCI) for acute STEMI between January 2011 and March 2013 were included in our study. Transfer parameters of symptom-to-reperfusion treatment, clinical characteristics, and laboratory parameters were recorded. Results: Thirty-six patients were admitted to our hospital with ambulances; 70 patients were admitted to centers without PCI capability, with a mean transfer time to our hospital of 73.9±12.5 min. Median pain-to-first medical contact time was 105 min (range: 5-600 min), and average first medical con- tact-to-balloon time was 115.5 min (range: 20-414 min). Total pain-to-balloon time in females was significantly higher than males (246 min [range: 70-840 min], 195 min [range: 45-684 min], respectively, p0.032). Mean pain-to-balloon time was significantly lower in patients delivered to the hospital by am- bulance than in patients admitted to emergency departments independently (185 min [range: 45-439 min], 248 min [range: 65-840 min], respectively, p0.017). Conclusion: In this study, our hospital door-to-balloon time was found compatible with the target specified in the European So- ciety of Cardiology and American College of Cardiology STEMI guidelines; however, first medical contact-to-balloon time was found to be above that advised by the current guidelines
Açıklama
Anahtar Kelimeler
Kalp ve Kalp Damar Sistemi
Kaynak
Türk Kardiyoloji Derneği Arşivi
WoS Q Değeri
Scopus Q Değeri
Cilt
44
Sayı
1
