Horvat Davor, Grman Janko
Department of Medicine, Karlovac General Hospital, Karlovac, Croatia.
Acta Med Croatica. 2009 Feb;63(1):99-101.
The aim of the study was to determine circumstances of referring patients with ST-elevation myocardial infarction (STEMI) for urgent percutaneous coronary intervention (PCI).
Different forms of acute coronary syndrome (ACS) and circumstances of referring STEMI patients to Karlovac PCI from October 2005 to February 2008 were analyzed.
During the period of observation, 366 ACS patients were hospitalized. There were 37% of patients with unstable angina pectoris, 15% with myocardial infarction without ST-elevation (NSTEMI) and 48% with STEMI. Out of 176 STEMI patients, 52% had subacute infarction, 22% were referred for urgent PCI, 17% received fibrinolytic treatment, whereas in 9% of patients PCI and fibrinolysis were contradictory. Out of 30 patients with fibrinolysis, PCI was not carried out in 14 patients that arrived in hospital within 2-3 hours, 2 patients arrived after 6 hours, 3 patients were older than 75 and 11 patients refused invasive approach to treatment or it was personal estimate of the physician.
Accordingly, too many patients with subacute STEMI arrived in hospital. The success of PCI project would be even better if it was used in patients with unstable angina pectoris and NSTEMI.
本研究旨在确定将ST段抬高型心肌梗死（STEMI）患者转诊进行紧急经皮冠状动脉介入治疗（PCI）的情况。
分析了2005年10月至2008年2月期间不同形式的急性冠状动脉综合征（ACS）以及将STEMI患者转诊至卡尔洛瓦茨进行PCI的情况。
在观察期间，366例ACS患者住院。其中不稳定型心绞痛患者占37%，非ST段抬高型心肌梗死（NSTEMI）患者占15%，STEMI患者占48%。在176例STEMI患者中，52%为亚急性梗死，22%被转诊进行紧急PCI，17%接受了溶栓治疗，而9%的患者PCI和溶栓治疗相互矛盾。在30例接受溶栓治疗的患者中，14例在2至3小时内到达医院未进行PCI，2例在6小时后到达，3例年龄超过75岁，11例拒绝侵入性治疗方法或这是医生的个人判断。
因此，有太多亚急性STEMI患者到达医院。如果将PCI项目用于不稳定型心绞痛和NSTEMI患者，其成功率会更高。
