Augmentation du taux de décision de reperfusion myocardique des patients ayant un syndrome coronaire aigu avec sus-décalage du segment ST. Analyse du registre e-MUST (2002 à 2010) des SAMU/SMUR d’Île-de-France

Lapostolle, Frédéric; Bataille, Sophie; Tafflet, Muriel; Dupas, François; Laborne, François-Xavier; Mouranche, Xavier; Lefort, Hugues; Juliard, Jean‐Michel; Letarnec, Jean-Yves; Mapouata, Mireille; Lamhaut, Lionel; Cahun-Giraud, S.; Boche, Thévy; Jabre, P.; Spaulding, Christian; Jouven, Xavier; Lambert, Yves

doi:10.1016/j.lpm.2015.01.013

Cited by 6 publications

(8 citation statements)

References 14 publications

(15 reference statements)

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“…According to an exploratory study [ 8 ], a diagnosis of ACS was confirmed in 38% of chest pain unit patients managed in a Tunisia ED. To have an accuracy of 3%, we had to include at least 1005 patients with nontraumatic acute chest pain.…”

Section: Methodsmentioning

confidence: 99%

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Management of acute coronary syndrome in emergency departments: a cross sectional multicenter study (Tunisia)

et al. 2018

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BackgroundWe aimed to describe diagnosed acute coronary syndrome (ACS) and its care management and outcomes in emergency departments (EDs) and to determine related cardiovascular risk factors (CVRFs).MethodsWe conducted a cross sectional multicenter study that included 1173 adults admitted to EDs for acute chest pain (ACP) in 2015 at 14 sites in Tunisia. Data included patients’ baseline characteristics, diagnosis, treatment and output.ResultsACS represented 49.7% of non-traumatic chest pain [95% CI: 46.7–52.6]; 74.2% of ACS cases were unstable angina/non-ST-segment-elevation myocardial infarction (UA/NSTEMI). Males represented 67.4% of patients with ACS (p < 0.001). The median age was 60 years (IQR 52–70). Emergency medical service transportation was used in 11.9% of cases. The median duration between chest pain onset and ED arrival was two hours (Inter quartile ranges (IQR) 2–4 h). The age-standardized prevalence rate was 69.9/100,000 PY; the rate was 96.24 in men and 43.7 in women. In the multivariable analysis, CVRFs related to ST segment elevation myocardial infarction were age correlated to sex and active smoking. CVRFs related to UA/NSTEMI were age correlated to sex, familial and personal vascular history and type 2 diabetes. We reported 27 cases of major adverse cardiovascular events (20.0%) in patients with STEMI and 36 in patients with UA/NSTEMI (9.1%).ConclusionHalf of the patients consulting EDs with ACP had ACS. Emergency medical service transportation calls were rare. Management delays were acceptable. The risk of developing an UA/NSTEMI was equal to the number of CVRFs + 1. To improve patient outcomes, it is necessary to increase adherence to international management guidelines.

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Section: Methodsmentioning

confidence: 99%

“…Physicians must quickly recognize highly suspected acute coronary syndrome (ACS) [ 4 – 8 ]. The prevalence of ACS varies within regions in Tunisia, according to the level of urbanization and lifestyle habits.…”

Section: Introductionmentioning

confidence: 99%

Management of acute coronary syndrome in emergency departments: a cross sectional multicenter study (Tunisia)

et al. 2018

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“…Thus, assessing benefit–risk balance is far more complex than considering the only time of ischemia and accessibility to PCI, almost imposing a case-by-case strategy. Over the last 20 years, fibrinolysis of STEMI has almost disappeared in our region [8]. Meanwhile, patients’ age, time to first medical contact, pharmaceuticals, and accessibility to PCI haven’t changed.…”

mentioning

confidence: 99%

“…This means that the benefit and the risk of fibrinolysis were drastically unbalanced. This could partly explain the dramatic decrease in the use of fibrinolysis in our region [8]. Limited personal experience of fibrinolysis (only a third of respondents) and limited knowledge about contraindications could also contribute.…”

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confidence: 99%

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Benefit–risk balance of fibrinolytic therapy in ST-elevation myocardial infarction as evaluated by physicians

Pineda

Savary

Vromant

et al. 2023

European Journal of Emergency Medicine

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Évolution dans le temps et déterminants de l’entrée dans la filière de prise en charge « idéale » de l’infarctus aigu du myocarde. Étude EFIM

Lapostolle

Loyeau²,

Hadjem

et al. 2019

Journal Européen des Urgences et de Réanimation

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Augmentation du taux de décision de reperfusion myocardique des patients ayant un syndrome coronaire aigu avec sus-décalage du segment ST. Analyse du registre e-MUST (2002 à 2010) des SAMU/SMUR d’Île-de-France

Cited by 6 publications

References 14 publications

Management of acute coronary syndrome in emergency departments: a cross sectional multicenter study (Tunisia)

Management of acute coronary syndrome in emergency departments: a cross sectional multicenter study (Tunisia)

Benefit–risk balance of fibrinolytic therapy in ST-elevation myocardial infarction as evaluated by physicians

Évolution dans le temps et déterminants de l’entrée dans la filière de prise en charge « idéale » de l’infarctus aigu du myocarde. Étude EFIM

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