title: Treatment of a cohort of patients with acute myocardial infarction and ST-segment elevation.
abstract: BACKGROUND
  Although thrombolysis and primary CTA are well-established procedures, they are not administered in a large proportion of the patients with STEMI who arrive to the emergency rooms.
  
  
  OBJECTIVE
  Describe initial and final the results in a cohort of STEMI patients
  
  
  METHODS
  The study included, from hospital admission to the discharge, 158 patients diagnosed with STEMI, from a total of 351 patients with ACS admitted to hospitals in Campos dos Goytacazes, RJ, Brazil, between 2004 and 2006.
  
  
  RESULTS
  Of the 158 patients with STEMI, 67.7% arrived to the hospital within 180 minutes, 81.3% within 360 minutes, and 8.4% after twelve hours from the symptoms. Cinecoronariographic studies (148) were performed (93,7%). Lesions of over 70% were observed in 266 artery territories. The initial treatment was CTA in 41 (26%), thrombolytics in 50 (32%), 80% of success. Clinical treatment in 67 (42%). Approximately 35% of the patients should have undergone thrombolysis, but they didn't. During the final treatment, 93 CTAs were performed: 89 with angiographic success (95.7%), bleeding 2 (2.2%), subacute occlusion 2 (2.2%), trunk dissection 1 (1.1%), pseudoaneurism 1 (1.1%). No deaths during angioplasty; during evolution, there were two deaths (2.1%). Twelve patients underwent myocardial revascularization surgery (MRS), while 53 underwent clinical treatment, with 11 deaths (20.7%). Global lethality was 9.5%, considering the three types of treatment.
  
  
  CONCLUSIONS
  Patients were suitable for reperfusion, but one third of them did not have the procedure. Two deaths during evolution. The most predominant treatment was CTA, with low morbidity. Low global lethality.
authors.affiliation: Hospital Escola Alvaro Alvim, Faculdade de Medicina de Campos, Rio de Janeiro, RJ, Brasil. jamilsoares@uol.com.br
authors.forename: Jamil da Silva
authors.initials: Jda S
authors.lastname: Soares
authors.forename: Nelson Robson Mendes de
authors.initials: NR
authors.lastname: Souza
authors.forename: Jair
authors.initials: J
authors.lastname: Nogueira Filho
authors.forename: Cristiane C
authors.initials: CC
authors.lastname: Cunha
authors.forename: Georgina Severo
authors.initials: GS
authors.lastname: Ribeiro
authors.forename: Ronald Souza
authors.initials: RS
authors.lastname: Peixoto
authors.forename: Carlos Eduardo C
authors.initials: CE
authors.lastname: Soares
authors.forename: Leandro C
authors.initials: LC
authors.lastname: Soares
authors.forename: Aldo Franklyn
authors.initials: AF
authors.lastname: Reis
authors.forename: Carlos Augusto Cardozo de
authors.initials: CA
authors.lastname: Faria
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000706:statistics & numerical data; D004812:Epidemiologic Methods; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D015912:Thrombolytic Therapy / Q000706:statistics & numerical data; D013997:Time Factors; D055815:Young Adult
chemical_list: D005343:Fibrinolytic Agents