Author/Editor     Svenšek, Franc; Pišljar, Mateja; Golc, Jasmina; Sinkovič, Andreja
Title     In-hospital complications in patients with ST-elevation acute coronary syndromes in University Medical Centre Maribor
Translated title     Bolnišnični zapleti med zdravljenjem bolnikov z akutnim koronarnim sindromom in dvigom veznice ST v Univerzitetnem kliničnem centru Maribor
Type     članek
Source     Slov Kardiol
Vol. and No.     Letnik 8, št. 1-2
Publication year     2011
Volume     str. 18-23
Language     eng
Abstract     Background. Early reperfusion therapy such as primary percutaneous coronary intervention (PCI) can decrease the magnitude of ischemic necrosis, resulting in prevention of heart failure and mortality in patients with ST-elevation acute coronary syndromes (ACS). Our aim is to evaluate in-hospital treatment and complications in patients, admitted with ST-elevation ACS. Patients and methods. We retrospectively included 225 patients, admitted in 2008 to UKC Maribor due to ST-elevatioAn CSp, resented with chest pain, lasting up to 24 hours, unresponsive to sublingual nitrogliceryn in addition to ST-elevation or presumably new left bundle block on ECG. During in-hospital stay we registered comorbidities, admission Troponin I and the lipid profile, evolution of acute MI according to ECG changes and increase in Troponin I levels, as well as treatment and in-hospital complications. Results. Among comorbidities arterial hypertension (51.5%), dyslipidemia (33,78%) and diabetes (21,33%) were frequently encountered, prior MI in 12%, stroke 4,44% and smoking in 36.89%. Mean admission troponin I was 10,8 +/- 20,5 micro g/l, peak level 47,5 +/- 34,9 micro g/l. Q-MI developed in 27,78% of patients. 90.22% of patients were treated by primary PCI. We observed arrhythmias in 34,22% of patients, heart failure (Killip classes >/= II) in 33.78%, infection in 22,67%, mitral regurgitation in 21,78%, bleedings in 8,44%, reinfarctions in 2,67% and in-hospital mortality in 9.3%. Conclusions. In our patients with ST-elevation ACS we frequently observed comorbidities. In spite primary PCI was performed in 90% of patients, in-hospital mortality was 9,3%, in particular due to heart failure.
Summary     Izhodišča. Le zgodnje reperfuzijsko zdravljenje kot je primarna perkutani koronarni poseg (PCI) lahko zmanjša velikost ishemične nekroze ter prepreči smrt in pojav srčnega popuščanja pri bolnikih z akutnim koronarnim sindromom (AKS) in dvigom veznice ST. Naš cilj je bil oceniti bolnišnično zdravljenje in zaplete pri bolnikih z AKS in dvigom veznice ST. Bolniki in metode. Retrospektivno smo vključili 225 bolnikov, zdravljenih 2008 v UKC Maribor zaradi AKS z dvigom veznice ST. Bolniki so imeli prsno bolečino, ki je trajala do 24 ur in se ni odzvala na sublingvalni nitroglicerin ter dvig veznice ST ali novonastali levokračni blok v EKG. Med bolnišničnim zdravljenjem smo beležili prisotnost predhodnih kroničnih bolezni, lipidogram in troponin 1, pojav infarkta srca glede na spremembe v EKG in porast troponina I, bolnišnične zaplete in zdravljenje. Rezultati. Med predhodnimi kroničnimi boleznimi smo ugotavljali zlasti pogost pojav arterijske hipertenzije (51,5%), dislipidemije (33,78%) in sladkorne bolezni (21,33%), predhodni MI v 12%, možgansko kap 4,44% in kajenje pri 36,89%. Sprejemni troponin I je bil 10,8 +/- 20,5 mikro g/l, najvišji 47,5 +/- 34,9 mikro g/l. Q-MI se je razvil pri 27,78% bolnikov. 90,22% bolnikov je bilo zdravljenih s primarno PCI. Med zdravljenjem smo opazovali aritmije pri 34,22 % bolnikih, srčno popuščanje (Killip razred >/= II) pri 33,78%, okužbo pri 22,67%, mitralno regurgitacijo pri 21,78%, krvavitve pri 8,44%, vnovični infarkt pri 2,67%. 9,3% bolnikov je umrlo v bolnišnici. Zaključki. Naši bolniki z AKS in dvigom ST so imeli številne spremljajoče bolezni. Čeprav so bili v 90% zdravljeni s primarno PCI, je bila bolnišnična umrljivost 9,3%, predvsem na račun srčnega popuščanja.
Descriptors     ANGIOPLASTY, TRANSLUMINAL, PERCUTANEOUS CORONARY
HEART FAILURE, CONGESTIVE
ARRHYTHMIA
HOSPITAL MORTALITY
MYOCARDIAL ISCHEMIA
RETROSPECTIVE STUDIES
ELECTROCARDIOGRAPHY