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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
Machado, Guilherme Pinheiro; Pivatto Junior, Ferenando; Wainstein, Rodrigo; Araújo, Gustavo Neves de; Carpes, Christian Kunde; Lech, Mateus Correa; Valle, Felipe Homem; Bergoli, Luiz Carlos Corsetti; Gonçalves, Sandro Cadaval; Wainstein, Marco Vugman.
  • Machado, Guilherme Pinheiro; Universidade Federal do Rio Grande do Sul. Faculdade de Medicina. Rio Grande do Sul - RS. BR
  • Pivatto Junior, Ferenando; Hospital de Clínicas de Porto Alegre. Serviço de Cardiologia. Porto Alegre - RS. BR
  • Wainstein, Rodrigo; Hospital de Clínicas de Porto ALegre. Serviço de Cardiologia. Porto Alegre - RS. BR
  • Araújo, Gustavo Neves de; Hospital de Clínicas de Porto Alegre. Serviço de Cardiologia. Porto Alegre - RS. BR
  • Carpes, Christian Kunde; Universidade Federal do Rio Grande do Sul. Faculdade de Medicina. Rio Grande do Sul - RS. BR
  • Lech, Mateus Correa; Universidade Federal do Rio Grande do Sul. Faculdade de Medicina. Rio Grande do Sul - RS. BR
  • Valle, Felipe Homem; Hospital de Clínica de Porto Alegre. Faculdade de Medicina. Porto Alegre - RS. BR
  • Bergoli, Luiz Carlos Corsetti; Hospital de Clínicas de Porto Alegre. Faculdade de Medicina. Porto Alegre - RS. BR
  • Gonçalves, Sandro Cadaval; Hospital de Clínica de Porto Alegre. Faculdade de Medicina. Porto Alegre - RS. BR
  • Wainstein, Marco Vugman; Universidade Federal do Rio Grande do Sul. Faculdade de Medicina. Rio Grande do Sul - RS. BR
Int. j. cardiovasc. sci. (Impr.) ; 32(2): 125-133, mar.-abr. 2019. tab, graf
Article in English | LILACS | ID: biblio-988177
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
Subject(s)


Full text: Available Index: LILACS (Americas) Main subject: Tertiary Healthcare / Percutaneous Coronary Intervention / Myocardial Infarction Type of study: Etiology study / Practice guideline / Observational study / Risk factors Limits: Female / Humans / Male Country/Region as subject: South America / Brazil Language: English Journal: Int. j. cardiovasc. sci. (Impr.) Journal subject: Cardiology Year: 2019 Type: Article Affiliation country: Brazil Institution/Affiliation country: 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

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Full text: Available Index: LILACS (Americas) Main subject: Tertiary Healthcare / Percutaneous Coronary Intervention / Myocardial Infarction Type of study: Etiology study / Practice guideline / Observational study / Risk factors Limits: Female / Humans / Male Country/Region as subject: South America / Brazil Language: English Journal: Int. j. cardiovasc. sci. (Impr.) Journal subject: Cardiology Year: 2019 Type: Article Affiliation country: Brazil Institution/Affiliation country: 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