[Results of treating myocardial infarction patients with ST segment elevation in Górnoślaskim Ośrodku Kardiologii in Katowice].
BACKGROUND
Reperfusion therapy reduces mortality rate in patients with acute myocardial infarction with ST-segment elevation (STEMI).


OBJECTIVE
The aim of the study was to access the early outcome of patiens (pts) with STEMI admitted to Upper Silesian Cardiology Centre in 2002.


METHODS
957 pts with AMI were enrolled into the study. The influence of several factors on in-hospital mortality was analised.


RESULTS
Out of 957 pts 51 died during hospitalization (5,3%). Coronary angiography was performed in 98,0% of pts. Primary PTCA was performed in 94,5% of pts. Stents were implanted in 85,9% of patients who underwent PTCA. The following factors significantly contributed to increased mortality among pts with acute myocardial infarction: female sex (p<0,02), multivessel disease (p<0,05), age above 65 yrs (p<0,001), time from the onset of chest pain above 6 hours (p<0,01) and 12 hours (p<0,001). The use of GP IIB/IIIA inhibitors significantly reduced the mortality rate (p<0,05). Cardiogenic shock was the only independent factor of the increased risk of mortality in multivariate regression analysis (p<0,0001) with relative risk of death (RR 33,5). The mortality rate in pts with shock was 40,2%: 70,8% in case of conservative treatment, 70% in the group of failed PTCA and only 17,2% in the group of successful PTCA. Among pts who underwent primary PTCA the failure to restore coronary blood flow of the infarct related artery contributed to increased relative risk of death (RR 14,5) (p<0,001). Stents improved the survival rate (p<0,01). In PTCA group cardiogenic shock and failed PTCA were independent risk factors in multivariate regression analysis.


CONCLUSIONS
The results of our study show low rate of in-hospital mortality in pts without cardiogenic shock (1,2%). PTCA is highly successful method of treatment of pts with shock with mortality rate 17,2% in pts who underwent successful procedure.
III Klinika Kardiologii Sl. AM, Katowice. katmasl@mp.pl
Katarzyna
K
Maślankiewicz
Andrzej
A
Jaklik
Daniel
D
Jakubowski
Jerzy
J
Kośmider
Andrzej
A
Ochała
Mariusz
M
Skowerski
Krystian
K
Wita
Przemysław
P
Weglarz
Krzysztof
K
Zaorski
Paweł
P
Buszman
Janusz
J
Drzewiecki
Zbigniew
Z
Gasior
Maria
M
Gross
Maria
M
Trusz-Gluza
Michał
M
Tendera
D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000453:epidemiology; D004562:Electrocardiography; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D015425:Myocardial Reperfusion / Q000379:methods*; D012307:Risk Factors; D012770:Shock, Cardiogenic / Q000453:epidemiology; D015607:Stents; D015996:Survival Rate; D016896:Treatment Outcome