Treatment of a cohort of patients with acute myocardial infarction and ST-segment elevation.
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.
Soares
Jamil da Silva
Jda S
Hospital Escola Alvaro Alvim, Faculdade de Medicina de Campos, Rio de Janeiro, RJ, Brasil. jamilsoares@uol.com.br
Souza
Nelson Robson Mendes de
NR
Nogueira Filho
Jair
J
Cunha
Cristiane C
CC
Ribeiro
Georgina Severo
GS
Peixoto
Ronald Souza
RS
Soares
Carlos Eduardo C
CE
Soares
Leandro C
LC
Reis
Aldo Franklyn
AF
Faria
Carlos Augusto Cardozo de
CA
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
D005343:Fibrinolytic Agents