RESUMO
Aim of the study was assessment of efficacy of rendering urgent aid to patients with acute coronary syndrome (ACS) at prehospital stage on the territory of Khanty-Mansi Autonomous Okrug (KhMAO). The analysis showed that yearly about 5000 inhabitants of KhMAO-Yugra received prehospital medical care (30% because of acute myocardial infarction, 70% because of unstable angina). Over 3 years portion of persons requesting medical aid during first 3 hours after onset of pain attack increased 6.1%. Rate of prehospital fibrinolysis did not exceed 6.5%. Alteplase was used most often (79.7%). Late patient's appeal was among causes of rare application of thrombolytic therapy (41.8%). Most physicians responsible for prehospital care considered it necessary to refer patients with ACS directly to centers of interventional cardiology. The data obtained would promote improvement of quality of medical aid to ACS patients at prehospital stage.
Assuntos
Síndrome Coronariana Aguda/terapia , Assistência Ambulatorial/métodos , Serviços Médicos de Emergência/métodos , Fibrinolíticos/uso terapêutico , Terapia Trombolítica/métodos , Síndrome Coronariana Aguda/epidemiologia , Eletrocardiografia , Feminino , Seguimentos , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Federação Russa/epidemiologia , Taxa de Sobrevida/tendências , Fatores de TempoRESUMO
Since 2008 Cardiological Dispensary of Khanty-Mansi Autonomous Okrug "Center of Diagnostics and Cardiovascular Surgery" has been participating in Rossiysky Registry of Acute Coronary Syndrome. In this paper we present some of the results on the use of percutaneous coronary interventions, time intervals, characterizing urgent medical aid to patients with acute coronary syndrome, rate of complications, and mortality.
Assuntos
Síndrome Coronariana Aguda , Intervenção Coronária Percutânea , Complicações Pós-Operatórias/epidemiologia , Síndrome Coronariana Aguda/diagnóstico , Síndrome Coronariana Aguda/mortalidade , Síndrome Coronariana Aguda/cirurgia , Eletrocardiografia , Feminino , Mortalidade Hospitalar , Humanos , Masculino , Pessoa de Meia-Idade , Avaliação de Processos e Resultados em Cuidados de Saúde , Intervenção Coronária Percutânea/efeitos adversos , Intervenção Coronária Percutânea/métodos , Sistema de Registros/estatística & dados numéricos , Medição de Risco , Fatores de Risco , Federação Russa/epidemiologia , Taxa de Sobrevida , Tempo para o Tratamento/estatística & dados numéricos , Resultado do TratamentoRESUMO
AIM: To study the effects of intracoronary administration of the ischemic preconditioning (IP) trigger adenosine on the reduced incidence of percutaneous coronary intervention (PCI)-associated myocardial infarction (MI) and left ventricular (LV) systolic and contractile function in patients with type 2 diabetes mellitus (DM) during recanalization of chronic coronary occlusions (CCO). SUBJECTS AND METHODS: The patients were divided into 4 groups: 1) 45 patients without DM who received intracoronary placebo infusion; 2) 51 patients without DM who had 10 mg intracoronary adenosine during PCI; 3) 34 patients with type 2 DM who had intracoronary adenosine during PCI; 4) 37 with type 2 DM who received intracoronary placebo. Troponin I and the MB fraction of creatine phosphokinase were measured an hour before and 18-24 hours and 5 days after PCI. The authors estimated the incidence of PCI-associated MI according to the ESC/ACCF/AHA/WHF (2007) criteria and the time course of changes in LV ejection fraction (EF) and end-systolic volume (ESV) and end-diastolic volume, impaired LV local contractility index (ILVLCI) in 167 patients with CCO 1 day and 1 and 12 months after PCI. RESULTS: There was an improvement in myocardial systolic and contractile function after recanalization and stenting for CCO. The intracoronary adenosine groups showed significantly reduced incidence of PCI-associated MI, increased LV EF, and decreased LV ESV and ILVLCI as compared to the placebo groups. CONCLUSION: The intracoronary injection of the IP trigger adenosine is an effective and safe method to improve LV systolic and contractile function in patients with CCO and type 2 DM.
Assuntos
Adenosina/administração & dosagem , Oclusão Coronária/tratamento farmacológico , Diabetes Mellitus Tipo 2/epidemiologia , Infarto do Miocárdio/etiologia , Intervenção Coronária Percutânea/efeitos adversos , Vasodilatadores/administração & dosagem , Função Ventricular Esquerda/fisiologia , Doença Crônica , Comorbidade , Oclusão Coronária/epidemiologia , Diabetes Mellitus Tipo 2/fisiopatologia , Humanos , Incidência , Infusões Intra-Arteriais , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/fisiopatologia , Placebos , Complicações Pós-OperatóriasRESUMO
Diovan (valsartan) in dose 160 mg/day was given to 20 patients with mild and moderate arterial hypertension living in the Far North. The treatment was carried out during 4 weeks and its influence on circadian BP, lipid, carbohydrate and water-salt exchange was studied. Antihypertensive activity and tolerance to the medication were also analyzed.