Impact of creating a hemodynamics room, a coronary care unit, and a primary angioplasty program on the prognosis of acute coronary syndrome in a district hospital.
Rev Clin Esp (Barc)
; 221(4): 187-197, 2021 Apr.
Article
en En
| MEDLINE
| ID: mdl-33998497
ABSTRACT
OBJECTIVE:
This work aims to analyze the prognosis and mortality of patients hospitalized for acute coronary syndrome before and after the implementation of a coronary care unit, hemodynamics room, and the Código Corazón [Infarction Code] primary angioplasty program.METHODS:
We conducted an observational, retrospective study that analyzed the epidemiological characteristics, reperfusion strategies, adverse cardiovascular events, and mortality over a follow-up period of five years. The results from the post-code period (March 1 - December 31, 2012; n=471) were compared with those from the pre-code period (March 1 - December 31, 2009; n=432).RESULTS:
There were no differences in the baseline characteristics of the two groups. However, an increase in ST-elevation acute coronary syndrome (STE-ACS) from 17.6% to 34.8% (p<.001) was observed during the postcode phase. The use of percutaneous coronary intervention was made widespread at the hospital and was used in 64.8% of non-ST-elevation acute coronary syndrome (NSTE-ACS) cases and in 95.5% of STE-ACS cases. A reduction was observed in readmissions (from 38.2% to 25.1% for NSTE-ACS (p=.001) and from 23.7% to 11.0% for STE-ACS (p=.018)), the composite prognostic variable of adverse cardiovascular events and 5-year mortality (from 58.7% to 45% (p=.001) for NSTE-ACS and from 40.8% to 23.8% (p=.009) for STE-ACS), and a decrease in 30-day mortality in STE-ACS (from 11.8% to 3.7%; p=.021).CONCLUSIONS:
With the structural changes in the hospital, the use of percutaneous coronary intervention was made widespread and improved the prognosis of patients with acute coronary syndrome, decreasing admissions, adverse cardiovascular events, and mortality.Palabras clave
Acute myocardial infarction; Código infarto; Infarction code; Infarto agudo de miocardio; Intervencionismo coronario percutáneo; Mortalidad; Mortality; Non-ST-elevation acute coronary syndrome; Percutaneous coronary intervention; ST-elevation acute coronary syndrome; Síndrome coronario agudo con elevación del ST; Síndrome coronario agudo sin elevación del ST
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Síndrome Coronario Agudo
Tipo de estudio:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Humans
Idioma:
En
Revista:
Rev Clin Esp (Barc)
Año:
2021
Tipo del documento:
Article