An overview of care change in the last 6 year in primary PCI in ST-elevation myocardial infarction in a Tertiary University Brazilian Hospital / Panorama da mudança do cuidado nos últimos 6 anos na ICP primária em infarto agudo do miocárdio com supradesnivelamento do segmento ST em hospital universitário de nível terciário
Int. j. cardiovasc. sci. (Impr.)
; 32(2): 125-133, mar.-abr. 2019. tab, graf
Artículo
en Inglés
| LILACS
| ID: biblio-988177
Biblioteca responsable:
BR44.1
Ubicación: BR44.1
ABSTRACT
Background:
Although new studies and guidelines can be considered useful tools, it does not necessarily mean they are put into clinical practice.Objective:
The aim of the current analysis was to assess the changes in primary percutaneous coronary intervention (PCI) and mortality in a tertiary university hospital in southern Brazil during a six-year period .Methods:
We have included consecutive patients with ST-elevation myocardial infarction (STEMI) who underwent primary PCI between March 2011 and February 2017. Previous clinical history, characteristics of the procedure, and reperfusion strategies were collected. In-hospital, short and long-term mortalities were also evaluated. The significance level adopted for all tests was 5%.Results:
There was an increase in the use of radial access in patients from 20.0% in 2011 to 62.7% in 2016 (ptrend < 0.0001). Moreover, thrombus aspiration decreased significantly from 66.7% in 2011 to less than 3.0% in 2016 (ptrend < 0.0001). In-hospital, short and long-term mortalities remained reasonably stable from 2011 to 2016 (ptrend > 0.05). However, a lower in-hospital mortality was observed in patients treated through radial access (p < 0.001). Cardiogenic shock occurred in 11.1%, without statistical differences in the period (ptrend = 0.39), while long-term mortality rate decreased from 80.0% in 2011 to 27.3% in 2016 in this patient group (ptrend = 0.29).Conclusions:
During a 6-year follow-up period, primary PCI characteristics underwent important modifications. Radial access became widely used, with a decrease in mortality with the use of this route, while aspiration thrombectomy became a rare procedure. The incidence of cardiogenic shock remained stable, but has shown a reduction in its mortality
Texto completo:
Disponible
Colección:
Bases de datos internacionales
Contexto en salud:
ODS3 - Meta 3.4 Reducir las muertes prematuras por enfermedades no transmisibles
Problema de salud:
Hypertension Arterial
/
Enfermedad Cardiovascular
/
Enfermedad Cerebrovascular
/
Enfermedades del Sistema Endocrino
/
Isquemia Miocárdica
Base de datos:
LILACS
Asunto principal:
Atención Terciaria de Salud
/
Intervención Coronaria Percutánea
/
Infarto del Miocardio
Tipo de estudio:
Estudio de etiología
/
Guía de práctica clínica
/
Estudio observacional
/
Factores de riesgo
Límite:
Femenino
/
Humanos
/
Masculino
País/Región como asunto:
America del Sur
/
Brasil
Idioma:
Inglés
Revista:
Int. j. cardiovasc. sci. (Impr.)
Asunto de la revista:
Cardiología
Año:
2019
Tipo del documento:
Artículo
País de afiliación:
Brasil
Institución/País de afiliación:
Hospital de Clínica de Porto Alegre/BR
/
Hospital de Clínicas de Porto ALegre/BR
/
Hospital de Clínicas de Porto Alegre/BR
/
Universidade Federal do Rio Grande do Sul/BR