Hospital mortality trend analysis of patients with ST elevation myocardial infarction in the Belgrade area coronary care units

Vasiljević, Zorana; Stojanović, Bojan; Kocev, Nikola; Stefanović, Branislav; Mrdović, Igor; Ostojić, Miodrag; Krotin, Mirjana; Putniković, Biljana; Dimković, Siniša; Despotović, N

doi:10.2298/sarh08s2084v

Cited by 10 publications

(12 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In this study Mortality rate was higher in Anterior wall MI as compared to inferior wall MI (19.5% vs. 13.5%) which is comparable to the study done by Vesilijevis et al (2008) 18 with mortality rate 21.4% vs. 12.2%. Right ventricular infarction and conduction system abnormalities encountered in many patients with inferior wall MI might explain this disparity in the mortality rates.…”

Section: Discussionsupporting

confidence: 88%

Incidence of Various Arrhythmias and Its Prognosis in Different Types of St Segment Elevation Myocardial Infarction in First 72 Hours

Sinha¹,

Agrawal²,

Jain³

2018

jebmh

View full text Add to dashboard Cite

BACKGROUND ST elevation myocardial infarction is an acute emergency, more than 50% of deaths due to STEMI occur within first 1 hour, mainly due to various arrhythmias. Various arrhythmia can complicate the course of STEMI. This study was done to access the incidence and pattern of arrhythmias complicating STEMI and the prognostic implications of these arrhythmias. MATERIALS AND METHODS 100 patients were included in the study that fulfilled the required criteria. They underwent detailed history taking and systemic examination. Patients were monitored through cardiac monitor and serial ECG recording were taken specially if any rhythm disturbances were observed and data was entered in a pretested proforma. RESULTS Among 100 patients, 60 were male and 40 were female. Commonest arrhythmias noticed in this study were sinus tachycardia (31%), followed by bundle branch block (30%), ventricular arrhythmia (25%) AV blocks (20%) sinus bradycardia (18%), supraventricular arrhythmia (4%) and AIVR in 1%. Mortality was more in patients with ventricular tachycardia and complete heart block. Majority of arrhythmias (76%) occur during first hour of hospitalization. CONCLUSION The commonest arrhythmia encountered were sinus tachycardia followed by bundle branch block (BBB), AV block and sinus bradycardia, AV block and sinus bradycardia were common with IWMI and ventricular arrhythmia and bundle branch block were common with AWMI.

show abstract

Section: Discussionsupporting

confidence: 88%

Incidence of Various Arrhythmias and Its Prognosis in Different Types of St Segment Elevation Myocardial Infarction in First 72 Hours

Sinha¹,

Agrawal²,

Jain³

2018

jebmh

View full text Add to dashboard Cite

show abstract

“…Those national data already published are listed in the references section 9–27 and the names of ongoing registries and/or surveys are listed in the appendix and more details in Table 1 .…”

Section: Methodsmentioning

confidence: 99%

Reperfusion therapy for ST elevation acute myocardial infarction in Europe: description of the current situation in 30 countries

Widimský

Wijns

Fajadet

et al. 2009

European Heart Journal

564

295

View full text Add to dashboard Cite

AimsPatient access to reperfusion therapy and the use of primary percutaneous coronary intervention (p-PCI) or thrombolysis (TL) varies considerably between European countries. The aim of this study was to obtain a realistic contemporary picture of how patients with ST elevation myocardial infarction (STEMI) are treated in different European countries.Methods and resultsThe chairpersons of the national working groups/societies of interventional cardiology in European countries and selected experts known to be involved in the national registries joined the writing group upon invitation. Data were collected about the country and any existing national STEMI or PCI registries, about STEMI epidemiology, and treatment in each given country and about PCI and p-PCI centres and procedures in each country. Results from the national and/or regional registries in 30 countries were included in this analysis. The annual incidence of hospital admission for any acute myocardial infarction (AMI) varied between 90–312/100 thousand/year, the incidence of STEMI alone ranging from 44 to 142. Primary PCI was the dominant reperfusion strategy in 16 countries and TL in 8 countries. The use of a p-PCI strategy varied between 5 and 92% (of all STEMI patients) and the use of TL between 0 and 55%. Any reperfusion treatment (p-PCI or TL) was used in 37–93% of STEMI patients. Significantly less reperfusion therapy was used in those countries where TL was the dominant strategy. The number of p-PCI procedures per million per year varied among countries between 20 and 970. The mean population served by a single p-PCI centre varied between 0.3 and 7.4 million inhabitants. In those countries offering p-PCI services to the majority of their STEMI patients, this population varied between 0.3 and 1.1 million per centre. In-hospital mortality of all consecutive STEMI patients varied between 4.2 and 13.5%, for patients treated by TL between 3.5 and 14% and for patients treated by p-PCI between 2.7 and 8%. The time reported from symptom onset to the first medical contact (FMC) varied between 60 and 210 min, FMC-needle time for TL between 30 and 110 min, and FMC-balloon time for p-PCI between 60 and 177 min.ConclusionMost North, West, and Central European countries used p-PCI for the majority of their STEMI patients. The lack of organized p-PCI networks was associated with fewer patients overall receiving some form of reperfusion therapy.

show abstract

“…We used the data of the Hospital National Registry for Acute Coronary Syndrome of Serbia (HORACS). 9,11 The registry was filled-in by the attending physicians in the 54 Coronary Care Units (CCU) in Serbia for all the pts with an acute coronary syndrome (ACS). There were 7 primary PCI centres and 2 were open round-the-clock (24h/7days).…”

Section: Data Collection and The Study Populationmentioning

confidence: 99%

“…8 In Serbia, however, the overall proportion of untimely reperfused eligible STEMI patients remains high. 9 It might be the caused the insufficient PCI network or unused PI therapy [9][10][11] The cardiovascular outcome is different between Eastern and Western European countries [12][13][14][15][16] and the performance measures for reperfusion in STEMI has significantly improved with a greater use of pPCI. 17 However, it is not clear that PI strategy is the same important as pPCI in developing and transition countries.…”

Section: Introductionmentioning

confidence: 99%

The use of reperfusion therapy in transition countries without fully applicable pharmacoinvasive strategy

Krljanać

Ašanin

Mickovski-Katalina

et al. 2022

VSP

Self Cite

View full text Add to dashboard Cite

Background/Aim: The pharmaco-invasive (PI) therapy is recommended strategy in patients (pts) with ST elevation myocardial infarction (STEMI) unable to undergo timely primary percutaneous coronary intervention (pPCI). The primary endpoint was to find the cohorts of pts who are not treated by any reperfusion therapy (RT) and the second endpoint was to see the outcome of the pts treated with RT, in a transition country without fully applicable PI therapy. Methods:The data used are those of the Hospital National Registry for Acute Coronary Syndrome of Serbia (HORACS). Results:The significant predictors of the withdrawing of the application of any RT in the model (c 75.6%, SE 0.004, 95% CI 0.748-0.761) were age (≥65 yr), heart failure (Killip II-IV), diabetes, and the time to first medical contact (FMC) (>360 min). In patients without RT, mortality was 15.7%, in pts treated with fibrinolysis (FT) was 10.5% and in pts treated with pPCI was 6.2% (p<0.000). Within 3 hours to FMC, higher in-hospital mortality was in FT pts (FT 8.7% vs. pPCI 4.3%). FT treated patients were older, had more comorbidities and heart failure (HF). However, after propensity score matching, in order to adjust the differences among the pts, the mortality rate remained higher, but not statistically significant (FT 8.8%. vs. pPCI 6.4%). Conclusions:The balance of the best cost-benefit strategies for better use of RT is difficult to achieve in transition countries. The possibility for timely pPCI and PI therapy is not applicable, in high risk patients, older, pts with HF and diabetes, especially. Key words: acute myocardial infarction with ST elevation, reperfusion therapy, transition countries, high-risk patientsZaključak: Primena reperfuzione terapije, uz postignuti idealan balans potrošnje i koristi je teško izvodljiva u zemljama u tranziciji. Mogućnosti za blagovremenu primenu pPCI, kao i FI terapije, posebno su ograničene kod visoko rizičnih, starijih bolesnika, kod bolesnika sa znacima SI, komorbiditetima i dijabetesom.Ključne reči: akutni infarkt miokarda sa ST elevacijom, reperfuziona terapija, zemlje u tranziciji, visoko rizični bolesnici

show abstract

Hospital mortality trend analysis of patients with ST elevation myocardial infarction in the Belgrade area coronary care units

Cited by 10 publications

References 19 publications

Incidence of Various Arrhythmias and Its Prognosis in Different Types of St Segment Elevation Myocardial Infarction in First 72 Hours

Incidence of Various Arrhythmias and Its Prognosis in Different Types of St Segment Elevation Myocardial Infarction in First 72 Hours

Reperfusion therapy for ST elevation acute myocardial infarction in Europe: description of the current situation in 30 countries

The use of reperfusion therapy in transition countries without fully applicable pharmacoinvasive strategy

Contact Info

Product

Resources

About