Pate G E, Curtin R, Talbot A, Murphy R T, Ward D, Barry M, Crean P, Foley J B, Walsh M J
Department of Cardiology, CResT Directorate, Saint James' Hospital, Dublin 8.
Ir Med J. 2002 Oct;95(9):274-6.
Saint James' Hospital is a 650-bed tertiary referral hospital. An audit was performed of acute transmural myocardial infarctions for the years 1996 to 1999 inclusive. On average there were 2043 cardiology admissions annually, 9.8% of all hospital admissions. Acute transmural myocardial infarction was diagnosed in 178 patients annually, and was less common during the summer. The figure of 72% receiving revascularisation therapy (thrombolysis 67%, primary angioplasty 5%) compares favourably with 35% in 1992. The main reason for not receiving thrombolysis was late presentation (15%) with contraindications present in only 5%. The case fatality rate was 16% confirming the higher mortality in clinical practice than that of thrombolytic trials. The prescription of aspirin or warfarin (99%) and betablockers (67%) was in line with international trials. The use of angiotensin converting enzyme inhibitors (34%) and statins (28%) is similar to other studies but less than would be expected according to trial evidence.
圣詹姆斯医院是一家拥有650张床位的三级转诊医院。对1996年至1999年（含）期间的急性透壁性心肌梗死进行了一项审计。平均每年有2043例心脏病科住院患者，占所有医院住院患者的9.8%。每年有178例患者被诊断为急性透壁性心肌梗死，夏季较为少见。接受血运重建治疗的比例为72%（溶栓治疗占67%，直接血管成形术占5%），与1992年的35%相比更具优势。未接受溶栓治疗的主要原因是就诊延迟（15%），仅有5%的患者存在禁忌证。病死率为16%，证实临床实践中的死亡率高于溶栓试验中的死亡率。阿司匹林或华法林（99%）和β受体阻滞剂（67%）的处方符合国际试验标准。血管紧张素转换酶抑制剂（34%）和他汀类药物（28%）的使用情况与其他研究相似，但低于试验证据所预期的水平。
