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- Title
TIMOČKA MREŽA ZBRINJAVANJA PACIJENATA SA AKUTNIM INFARKTOM MIOKARDA.
- Authors
Mitov, Vladimir; Nedeljković, Milan A.; Jolić, Aleksandar; Adamović, Dragana; Dimitrijević, Marko; Nikolić, Milan
- Abstract
The aim of this paper is presentation of the first results of Zajecar invasive cardiology during the period of March 2014 to September 2017. Material and methods:During this period we had 310 pts, there were 216 (69,90%) male, and 93 (30,10%) female pts, the average age was 63,15±11,85 years. We had 263 (84,84%) pts with STEMI and 47 (15,16%) pts with NSTEMI and pPCI.Femoral approach was used in 116 pts (37,42%) and radial approach in 194 pts (62,58%). Results:The average time from pain onset to first medical contact was 182 minutes. The transport to our angiography theater took in average 90 minutes, and the time from admittance in our ward to the wire passing of the lesion was in average 45 minutes. In patients who presented as STEMI, angiographically TIMI 0 in the culprit vessel was found in 160 160 (60,84%) pts, TIMI ≥ I was found in 103 (39,16%) pts. Patients who presented as NSTEMI, had an angiographic finding of TIMI 0 in culprit vessel in 11 (23,41%) pts, and TIMI ≥ I in 36 (76,59%) pts. Beside the culprit vessel, all the other heart vessels were analyzed. In STEMI patients, 156 (59,33%) pts had angiographic changes on the culprit vessel only, while 107 (40,67%) pts had more than one vessel affected. Idenctical ratio was found in NSTEMI patients, with 28 (59,59%) pts with culprit vessel only affected, and 19 (40,41%) had more than one vessel affected. Conclusion: The greatest number of patients were with STEMI presentation, 40% of those had some flow in the culprit vessel on the angiography. 15.16% of the patients were with the NSTEMI presentation, of which almost a quarter had ocluded culprit vessel. Equal ratio of patients with STEMI and NSTEMI presenstation had more than culprit vessel affected, effectively, slightly less than a half of them. Active education of general population should be executed in order to shorten the time from pain onset to irst medical contact and STEMI diagnosis. Prosečno vreme od početka bola do prvog medicinskog kontakta iznosilo je 182 minuta, transport do angio sale je trajao 90 minuta u proseku, a od prijema do otvaranja infarktne arterije u proseku je bilo potrebno 45 minuta. Kod pts sa STEMI prezentacijom, angiografski je kod 160 (60,84%) nađen TIMI 0 protok, ali i kod 103 (39,16%) pts angografski je nađeno TIMI ≥ I protok kroz infarktnu arteriju. Kod pts sa NSTEMI prezentacijom na prijemu kod 11 (23,41%) bio je TIMI 0 protok kroz infarktnu arteriju, a kod 36 (76,59%) pts nađen je TIMI ≥ I protok krvi. Pored infarktne arterije analizirane su i promene na ostalim arterijama. Kod pts sa STEMI 156 (59,33%) imalo je promenu samo na infarktnoj arteriji, 107 (40,67%) imalo je višesudovnu koronarnu bolest. Identičan odnos bio je i kod NSTEMI pts 28 (59,59%) imala je promenu samo na infarktnoj arteriji, 19 (40,41%) je imalo više sudovnu koronarnu bolest. Conclusion: Najveći broj lečenih pacijenata imali su akutni infarkt miokarda sa ST elevacijom, od kojih je 40% imalo protok kroz infarktu arteriju na koronarografiji. Bilo je 15,16% pacijenata sa infarktom miokarda bez ST elevacije, od kojih je skoro četvrtina imala okluziju infarktne koronarne arterije. Kod pacijenta sa infarktom miokarda sa ili bez ST elevacije podjednak broj je bio sa višesudovnom koronarnom bolešću, nešto manje od polovine. Aktivnom medijskom kampanjom potrebno je sprovesti edukaciju stanovništa kako bi se skratilo vreme od početka bola do prvog medicinskog kontakta.
- Publication
Timocki Medicinski Glasnik, 2018, Vol 43, p110
- ISSN
0350-2899
- Publication type
Article