Cardiological Clinic, University Hospital and VÚSCH, Košice, Bratislava, Slovak Republic.
J Cardiovasc Med (Hagerstown). 2011 May;12(5):353-5. doi: 10.2459/JCM.0b013e328344e630.
This study analysed the implementation of official European Society of Cardiology (ESC) guidelines for the management of ST elevated myocardial infarction (STEMI) patients. Initiatives were aimed at the education of both healthcare professionals and inhabitants. Changes in clinical practice and clinical outputs were analysed using data acquired from the SLOVak registry of Acute Coronary Syndromes (SLOVAKS). From 2007 to 2008 positive changes were noticed at every level of the 'life chain'. The proportion of patients treated by primary percutaneous coronary intervention (PCI) and by early reperfusion rose significantly. Total ischaemic time was shortened by 12 min in patients treated by thrombolysis and by 26 min in patients treated by PCI. In-hospital lethality for STEMI decreased significantly. The weakest point in the management of STEMI patients in Slovakia was the still-significant time loss incurred by patients themselves. Targeted initiatives aimed at implementing official ESC guidelines can significantly improve clinical outcomes in a relatively short period of time.
本研究分析了官方欧洲心脏病学会(ESC)指南在管理 ST 段抬高型心肌梗死(STEMI)患者方面的实施情况。这些举措旨在对医疗保健专业人员和居民进行教育。通过从斯洛伐克急性冠状动脉综合征登记处(SLOVAKS)获取的数据,分析了临床实践和临床结果的变化。从 2007 年到 2008 年,在“生命链”的每个层面都注意到了积极的变化。接受直接经皮冠状动脉介入治疗(PCI)和早期再灌注治疗的患者比例显著上升。接受溶栓治疗的患者总缺血时间缩短了 12 分钟,接受 PCI 治疗的患者缩短了 26 分钟。STEMI 患者的院内死亡率显著下降。在斯洛伐克,STEMI 患者管理的薄弱环节是患者自身仍会遭受显著的时间损失。有针对性的举措旨在实施官方 ESC 指南,可以在相对较短的时间内显著改善临床结果。