Interv Akut Kardiol. 2002;1(1):28-31

Mortality of patients with acute myocardial infarction at the Coronary Care Unit in the University Hospital Brno-Bohunice

Stanislav Janoušek, Radka Adámková, Martin Tesák, Kateřina Buchtová, Jan Maňoušek

Interní kardiologická klinika FN a LF MU v Brně

Aim of study: There is significant progress in the treatment of acute myocardial infarction (AMI) due to reperfusion therapy. The aim of our study was to analyze from that point of view treatment of AMI at the our coronary care unit (CCU) during the one year period with established 24-hours´ duty of acute coronarography with the special attention to the mortality.

Methods: The retrospective analysis of all patients admitted at the CCU under diagnosis of AMI during the year 2002. These were 305 persons (198 men, mean age 67 ± 13 years, range 30–96 years) and that group was 61 % of all 504 patients admitted to the CCU. The analysis was performed by the basic statistic tests (mean, standard deviation, t-test, etc.).

Results: By acute percutaneous coronary intervention (PCI) were treated 159 patients (52,1 %, mean age 63 ± 13 years, range 38–96 years), by IV thrombolysis 21 patients (6,9 %, mean age 70 ± 13 year), and 125 patients (41 %, mean age 70 ± 13 years, range 30–95 years) did not undergo any reperfusion treatment.

Mortality of all patients with AMI during the hospitalization was 7,9 % (24/306). In the group treated by primary acute PCI was 5,0 % (8/159), in the IV thrombolysis group was 9,5 % (2/21) and in the rest of patients 11,2 % (14/125). The reason why the reperfusion treatment was not performed were in 58 (46,4 %) late arrival (mortality 4/58 = 6,9 %), 28 patients (22,4 %) did not complete ECG criteria (mortality 1/28 = 3,5 %), 21 patients (16,8 %) had no chest pain on admission (mortality 2/21 = 9,5%), 8 patients (6,4 %) were admitted in very serious condition (mortality 6/8 = 75 %), at 8 (6,4 %) was this reason unknown (mortality 1/8 = 12,5 %) and at 2 patients were present contraindications of reperfusion therapy (mortality 0/2 = 0,0 %).

Conclusions: 1. Patients with AMI were the most frequent group admitted at CCU. 2. The lowest mortality were noticed in patients with AMI treated by primary acute PCI. 3. In spite of 24-hours´ duty of acute coronarography the total mortality patients with AMI is still relatively high. 4. The main reason is relatively high rate of patients without reperfusion therapy. The precise analysis of this group could further decrease the mortality of patients with AMI.

Keywords: coronary care unit, acute myocardial infarction, reperfusion therapy, PTCA, mortality.

Published: December 31, 2002  Show citation