| Autor: |
Wagner, S., Burczyk, U., Schiele, R., Bergmeier, C., Rustige, J., Gottwik, M., Senges, J. |
| Zdroj: |
European Heart Journal; Jun1998, Vol. 19 Issue 6, p879-884, 6p |
| Abstrakt: |
PurposeThe purpose of the study was to evaluate parameters that characterize patients with myocardial reinfarction as compared to patients with a first infarction in clinical practice, and possibly to determine their clinical outcome.Methods The 60 Minutes Myocardial Infarction Project is a German multicentre prospective observational study in which l36 hospitals are participating. Fourteen thousand, nine hundred and eighty consecutive patients with acute Q wave myocardial infarction were included from July 1992 to September 1994.Results Out of these 14980 patients, there were 2854 (19%) with reinfarction and 12126 (81%) with a first infarction. Patients with a reinfarction arrived at the hospital 24 min earlier than patients with a first infarction (pre-hospital delay 156 vs 180 min; P<0.001); the door-toneedle time with reinfarction was longer (38 vs 30 min; P<0.001); however, patients with reinfarction were older (69 vs 66 years; P<0.001), had a lower rate of a diagnostic first ECG (54 vs 71%; P<0.001) and received thrombolytic therapy less frequently than patients with a first infarction (46 vs 52%; P<0.001). A low number of patients received primary PTCA (n=205) since only a few hospitals offered a primary PTCA service at the time the study was performed. In patients with reinfarction, there were more reasons as to why thrombolytic therapy was not given (24 vs 21%; P<0.001). Left bundle branch block occurred more frequently in patients with reinfarction (15 vs 8%; P<0.001). The intra-hospital course in patients with reinfarction was associated with an increase of complications and intra-hospital death (23 vs 15%; P<0.001).Conclusions Although reinfarction patients arrived earlier at hospital than patients with a first infarction, the former received thrombolytic therapy less frequently than the latter. Patients with reinfarction were older, more frequently had a non-diagnostic ECG on admission and had a higher rate of contraindications against thrombolytic therapy. [ABSTRACT FROM PUBLISHER] |
| Databáze: |
Complementary Index |
| Externí odkaz: |
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