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Original Research

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Baseline characteristics, time-to-hospital admission and in-hospital outcomes of patients hospitalized with ST-segment elevation 

acute coronary syndromes, 2002 to 2005

  • ZLATKO PEHNEC 1
  • ANDREJA SINKOVIĆ1
  • BORUT KAMENIK1
  • MARTIN MARINŠEK1
  • FRANCI SVENŠEK1

1,Department of Internal Medicine University Hospital Maribor

DOI: 10.22514/SV41.042009.3 Vol.4,Issue 1,April 2009 pp.14-20

Published: 09 April 2009

*Corresponding Author(s): ZLATKO PEHNEC E-mail: zlatko. pehnec@ukc-mb.si

Abstract

Objective. The purpose of this study was to retrospectively determine baseline patient characteristics, time-to-hospital admission, utilization of reperfusion therapy and outcomes of patients hospitalized with ST-segment elevation acute coro-nary syndromes (ACS) between 2002 and 2005, particularly after 24-h primary percutaneous coronary intervention (PCI) was introduced in 2004.

Methods. Included were all patients admitted to the intensive care unit (ICU) from 2002 to 2005 who met the criteria for ACS. Information on patients’ demographic characteristics, medical history, time-to-hospital admission, clinical characteristics on admission, laboratory examinations, ECG findings, treatments, hospital duration, and in-hospital outcomes was collected by completing a standardized case report form. 

Results. There was a sustained increase in admissions between 2002 and 2005, altogether 899 patients were hospitalized. A significant decrease in time-to-hospital admission was achieved. More patients arrived within 4-6 hours (16.3% in 2002 vs. 31.5% in 2005) and less after 12 hours (35.0% in 2002 vs. 13.4% in 2005). A significant increase in primary PCI rate was achieved (16.9% in 2002 vs. 90% in 2005, P<0.001). Consequently, the rate of thrombolysis, postponed PCI and nonreper-fusion medical therapy decreased. From 2002 to 2005, total in-hospital stay decreased significantly (15.4±13.0 days vs. 7.8±8.5 days, P<0.001), in-hospital mortality insignificantly (11.3% vs. 7.2%). 

Conclusion. Despite the significant increase in primary PCI between 2002-2005, there was only an insignificant decre-ase in in-hospital mortality. Further shortening the time-to-hospital admission and increasing primary PCI among older hemodynamically unstable ACS patients, particularly those with cardiogenic shock, could achieve an additional decrease in mortality. 

Keywords

acute coronary syndrome, acute myocardial infarction, time-to-hospital admission, prognosis, man-agement, percutaneous coronary intervention, mortality

Cite and Share

ZLATKO PEHNEC ,ANDREJA SINKOVIĆ,BORUT KAMENIK,MARTIN MARINŠEK,FRANCI SVENŠEK. Baseline characteristics, time-to-hospital admission and in-hospital outcomes of patients hospitalized with ST-segment elevation acute coronary syndromes, 2002 to 2005. Signa Vitae. 2009. 4(1);14-20.

References

1. Van de Werf F, Ardissino D, Bertiu A, Cokkinos DV, Falk E, Fox KAA, et al. Management of acute myocardial infarction in patients presenting with ST-segment elevation. The Task Force on the Management of Acute Myocardial Infarction of the European Society of Cardiology. Eur Heart J 2003;4:28-66.

2. Antman EM, Anbe DT, Armstrong PW, Bates ER, Green LA, Hand M, et al. ACC/AHA guidelines for the management of patients with ST-elevation myocardial infarction-executive summary. A report of American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1999 Guidelines for the Management of Patients With Acute Myocardial Infarction). J Am Coll Cardiol 2004;44:671-719.

3. Antman EM, Hand M, Armstrong PW, Bates ER, Green LA, Halasyamani LK, et al. 2007 focused update of the ACC/AHA 2004 guidelines for management of patients with ST-elevation myocardial infarction: a report of American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 2008;51(2):210-47.

4. Barron HV, Bowlby LJ, Breen T, Rogers WJ, Canto JG, Zhang Y, et al. Use of reperfusion therapy for acute myocardial infarction in the United States: data from the National Registry of Myocardial Infarction 2. Circulation 1998;97:1150-6.

5. Larson DM, Sharkey SW, Unger BT, Henry TD. Implementation of acute myocardial infarction guidelines in community hospitals. Acad Emerg Med 2005;12:522-7.

6. Hasdai D, Behar S, Wallentin L, Danchin N, Gitt AK, Boersama E, et al. A prospective survey of the characteristics, treatments and outcomes of patients with acute coronary syndromes in Europe and Mediterranean basin; the Euro Heart Survey of Acute Coronary Syndromes (Euro Heart Survey ACS). Eur Heart J 2002;23:1190-201.

7. O􀀁Connor GT, Quinton HB, Traven ND, Ramunno LD, Dodds TA, Marciniak TA, et al. Geographic variation in the treatment of acute myo-cardial infarction: the Cooperative Cardiovascular Project. JAMA 1999;281:627-33.

8. Sheikh K, Bullock C. Urban-rural differences in quality of care for medical patients with acute myocardial infarction. Arch Intern Med 2001;161:737-43.

9. Zaletel-Kragelj L, Eržen I, Fras Z. Interregional differences in health in Slovenia. I. Estimated prevalence of selected cardiovascular and related diseases. Croat Med J 2004;45:637-43.

10. Cannon CP, Gipson DM, Lambrew CT, Soultz DA, Levy D, French WJ, et al. Relationship of symptom-onset-to-balloon time and door-to-balloon time with mortality in patients undergoing angioplasty for acute myocardial infarction. JAMA 2000;283(22):2941-7.

11. Reimer KA, Vander Heide RS, Richard VJ. Reperfusion in acute myocardial infarction: effect of timing and modulating factors in experi-mental models. Am J Cardiol 1993;72:13G-21G.

12. De Luca G, Suryapranata H, Ottervanger JP, Antman EM. Time delay to treatment and mortality in primary angioplasty for acute myocardial infarction: every minute of delay counts. Circulation 2004;109:1223-5.

13. De Luca G, Suryapranata H, Zijlstra F, van´t Hof AW, Hoorntje JCA, Gosselink ATM, et al, on behalf of the ZWOLLE Myocardial Infarction Study Group. Symptom-onset-to-balloon time and mortality in patients with acute myocardial infarction treated by primary angioplasty. J Am Coll Cardiol 2003;42:991-7.

14. De Luca G, van´t Hof AW, de Boer MJ, Ottervanger JP, Hoorntje JCA, Gosselink ATM, et al. Time-to-treatment significantly affects the extent of ST-segment resolution and myocardial blush in patients with acute myocardial infarction treated by primary angioplasty. Eur Heart J 2004;25:1009-13.

15. Keeley EC, Boura JA, Grines CL. Primary angioplasty versus intravenous thrombolytic therapy for acute myocardial infarction: a quantitative review of 23 randomized trials. Lancet 2003;361:13-20.

16. Andersen HR, Nielsen TT, Rasmussen K, Thuesen L, Kelbaek H, Thayssen P, et al, for DANAMI-2 Investigators. A comparison of coronary angioplasty with fibrinolitic therapy in acute myocardial infarction. N Engl J Med 2003;349:733-42.

17. Keeley EC, Boura JA, Grines CL. Comparison of primary and facilitated percutaneous coronary interventions for ST-elevation myocardial infarction: quantitative review of randomized trials. Lancet 2006;367:579-88.

18. Iakobishvili Z, Behar S, Boyko V, Battler A, Hasdai D. Does current treatment of cardiogenic shock complicating the acute coronary syn-dromes comply with guidelines? Am Heart J 2005;149:98-103.

19. McNamara RL, Herrin J, Bradley EH, Portnay EL, Curtis JP, Wang Y, et al, for the NRMI Investigators. Hospital improvement in time to reperfusion in patients with acute myocardial infarction, 1999 to 2002. J Am Coll Cardiol 2006;47:45-51.

20. Hochman JS, Sleeper LA, Webb JG, Sanborn TA, White HD, Talley JD, et al, for the SHOCK Investigators. Early revascularization in acute myocardial infarction complicated by cardiogenic shock. N Engl J Med 1999;341:625-34.

21. Kainth A, Hewitt A, Pattenden J, Sowden A, Duffy S, Watt I, et al. Systematic review of interventions to reduce delay in patients with sus-pected heart attack. Emerg Med J 2004;21:506-8.

22. Sinkovic A, Pehnec Z. In-hospital mortality and treatment in elderly patients with ST-elevation myocardial infarction. J Kardiol 2005;12:202-4.

23. Henry TD, Atkins JM, Cunningham MS, Francis GS, Groh WJ, Hong RA, et al. ST-segment elevation myocardial infarction: Recommenda-tions on triage of patients to heart attack centres. J Am Coll Cardiol 2006;47:1339-45.

24. Di Chiara A, Chiarella F, Savonitto S, Lucci D, Bolognese L, De Servi S, et al. Epidemiology of acute myocardial infarction in the Italian CCU network. The BLITZ study. Eur Heart J 2003;24:1616-29.

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