1. TRENDS IN TREATMENT AND OUTCOMES OF PATIENTS WITH ACUTE MYOCARDIAL INFARCTION WITHOUT ST ELEVATION IN CLINICAL HOSPITAL CENTRE RIJEKA
- Author
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Lenčić, Dominik, Tomulić, Vjekoslav, Gobić, David, Jakljević, Tomislav, and Belušić-Gobić, Margita
- Subjects
BIOMEDICINA I ZDRAVSTVO. Kliničke medicinske znanosti. Interna medicina ,troponin T ,Akutni koronarni sindrom ,primarna perkutana koronarna intervencija ,Acute coronary syndrome ,myocardial infarction without ST elevation ,infarkt miokarda bez ST elevacije ,primary percutaneous coronary intervention ,BIOMEDICINE AND HEALTHCARE. Clinical Medical Sciences. Internal Medicine - Abstract
Uvod: Kardiovaskularne bolesti predstavljaju jedan od vodećih uzroka smrti u svijetu. Akutni koronarni sindrom, kao jedan od sedam oblika koronarne bolesti srca, najčešći je oblik koji susrećemo u svakodnevnoj praksi. AKS se može podijeliti na tri različita klinička entiteta, NAP, STEMI i NSTEMI. Liječenje STEMI-a uključuje hitnu PCI i medikamentnu terapiju dok NAP predstavlja entitet koji zahtjeva medikamentno liječenje i praćenje zbog mogućnosti prelaska u IM. NSTEMI se liječi ovisno o stupnju rizika bolesnika te je, zbog specifičnosti u liječenju, predmet ovog istraživanja. Cilj: Cilj ovog istraživanja bio je dokazati razlike u načinu liječenja između dvije skupine bolesnika u razmaku od 5 godina te proučiti njihove ishode. Ispitanici i postupci: Ovo istraživanje je bilo retrospektivno. Provedeno je uvidom u podatke o liječenju ukupno 247 bolesnika preko informacijskog bolničkog sustava. Bolesnici su bili podijeljeni u dvije skupine, prva iz 2014. godine i druga iz 2019. godine. Uvjet za uključivanje u studiju je bio da su primljeni na Kliniku za bolesti srca i krvnih žila u KBC-u Rijeka između 1. siječnja i 31. travnja te otpušteni pod dijagnozom NSTEMI. Pratilo se hospitalno liječenje, ishodi i praćenje do 12 mjeseci nakon otpusta. Rezultati: Bolesnici liječeni 2014. godine imali su manje koronarografija i invazivnih terapijskih zahvata te su više bili liječeni standardnom medikamentnom terapijom. Kod bolesnika liječenih 2019. godine provedeno je više dijagnostičkih koronarografija i PCI-ja. Trajanje hospitalizacije značajno je skraćeno u drugoj skupini bolesnika. Ukupni broj MACE-eva, hospitalna i smrtnost u ukupnom praćenju od 12 mjeseci značajno su niži u bolesnika liječenih 2019. godine. Zaključak: Liječenje bolesnika s NSTEMI zahtjeva specifičan pristup temeljen na recentnim smjernicama. Dijagnostički i terapijski pristup ovim bolesnicima u KBC Rijeka pokazuje značajan kvalitativni pomak kroz ispitivane godine., Introduction: Cardiovascular diseases are one of the leading causes of death in the world. Acute coronary syndrome, as one of the seven forms of coronary heart diseases, is the most common form we encounter in everyday practice. Acute coronary syndrome can be divided into three different clinical entities, NAP, STEMI and NSTEMI. Treatment of STEMI includes emergency PCI and drug treatment while NAP is an entity that requires drug treatment and follow-up due to the possibility of transition to IM. NSTEMI is treated depending on the degree of risk of every patient and, due to the specificity of treatment, is the subject of this study. Aim: The aim of this study was to demonstrate differences in treatment between the two groups of patients 5 years apart and to study their outcomes. Materials and methods: This research was retrospective. A total of 247 patients were treated and the data of their treatment was collected through the hospital information system. Patients were divided into two groups, the first from year 2014 and the second from year 2019. The condition for inclusion in the study was that they were admitted to the Clinic for Cardiovascular Diseases at the University Hospital Center Rijeka between January 1st and April 31st and discharged under the diagnosis of NSTEMI. Hospital treatment, outcomes, and follow-up for up to 12 months after discharge were also monitored. Results: Patients treated in 2014 had fewer coronary angiograms and invasive treatments and were treated more with standard drug therapy. In patients treated in 2019, multiple diagnostic coronary angiograms and PCIs were performed. The duration of hospitalization was significantly shortened in the second group of patients. The total number of MACEs, hospitalizations, and mortality in the total follow-up of 12 months were significantly lower in patients treated in 2019. Conclusion: Treatment of patients with NSTEMI requires a specific approach based on recent guidelines. The diagnostic and therapeutic approach to these patients at the Clinical Hospital Centre Rijeka shows a significant qualitative shift through the examined years.
- Published
- 2020