ST-yükselmeli miyokart enfarktüsü ile başvuran hastaların transfer parametrelerinin değerlendirilmesi
Yükleniyor...
Dosyalar
Tarih
2016
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Turkish Soc Cardiology
Erişim Hakkı
info:eu-repo/semantics/closedAccess
Özet
Amaç: Akut koroner sendrom (AKS), ciddi morbidite ve mortalite ile seyreden yaygın bir hastalıktır. Hızlı damar reperfüzyonu, AKS alt tipi olan ST-yükselmeli miyokart enfarktüsü
(STYME) tedavisinin en önemli aşamasıdır. Sonuçların başarısı sadece merkezin deneyimine değil, reperfüzyonun ne
kadar kısa sürede sağlandığına da bağlıdır. Çalışmamızda
merkezimize başvuran STYME’li hastaların transfer parametreleri değerlendirildi.
Yöntemler: Çalışmamıza Ocak 2011-Mart 2013 tarihleri arasında, STYME nedeniyle primer perkütan koroner girişim
(PKG) uygulanan ardışık 200 hasta (160 erkek, 40 kadın) dahil 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 hastaların merkezimize transfer süresinin ortalama 73.9±12.5 dakika (dk) olduğu tespit edildi. Ağrı-ilk tıbbi temas süresinin
medyan 105 (dağılım, 5–600) dk, ilk tıbbi temas-balon süresinin 115.5 (dağılım, 20–414) dk olduğu görüldü. Kadınlarda toplam ağrı-balon süresi erkeklere göre anlamlı olarak
daha yüksekti (sırasıyla 246 [70–840]dk ve 195 [45–684] dk;
p=0.032). 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; p=0.017).
Sonuç: Çalışmamızda hastanemiz kapı-balon süresinin Avrupa Kardiyoloji Derneği ve Amerikan Kardiyoloji Koleji STEME
kılavuzu hedefleri ile uyumlu olduğu, ilk tıbbi temas-balon süresinin güncel kılavuz önerilerinin üzerinde olduğu saptandı.
Objective: Acute coronary syndrom (ACS) is a common disease that causes severe morbidity and mortality. The most important aspect of ST-elevation myocardial infarction (STEMI) as a subgroup of ACS treatment is the rapid reperfusion of arteries. 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 evaluated in patients who were admitted to our hospital with STEMI. Methods: Two hundred consecutive patients (160 males, 40 females) who underwent primary percutaneous coronary intervention (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 contact-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, p=0.032). Mean pain-to-balloon time was significantly lower in patients delivered to the hospital by ambulance than in patients admitted to emergency departments independently (185 min [range: 45–439 min], 248 min [range: 65–840 min], respectively, p=0.017). Conclusion: In this study, our hospital door-to-balloon time was found compatible with the target specified in the European Society 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 disease that causes severe morbidity and mortality. The most important aspect of ST-elevation myocardial infarction (STEMI) as a subgroup of ACS treatment is the rapid reperfusion of arteries. 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 evaluated in patients who were admitted to our hospital with STEMI. Methods: Two hundred consecutive patients (160 males, 40 females) who underwent primary percutaneous coronary intervention (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 contact-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, p=0.032). Mean pain-to-balloon time was significantly lower in patients delivered to the hospital by ambulance than in patients admitted to emergency departments independently (185 min [range: 45–439 min], 248 min [range: 65–840 min], respectively, p=0.017). Conclusion: In this study, our hospital door-to-balloon time was found compatible with the target specified in the European Society 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
WOS: 000371267200007
PubMed: 26875128
PubMed: 26875128
Anahtar Kelimeler
Acute coronary syndromes, chest pain, door-to-balloon time, primary angioplasty, ST elevation myocardial infarction
Kaynak
Turk Kardiyoloji Dernegi Arsivi-Archives Of The Turkish Society Of Cardiology
WoS Q Değeri
N/A
Scopus Q Değeri
Q4
Cilt
44
Sayı
1
