[Primary angioplasty in acute coronary syndromes with ST-segment elevation: experience of three Alsacian centers]
| Autor: | Hanssen M, Gottwalles Y, Jp, Monassier, Pierre Couppie, Boulenc J, Jacquemin L, De Poli F, Levai L, El Belghiti R |
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| Předmět: |
Adult
Aged 80 and over Male Time Factors Adolescent Age Factors Myocardial Infarction Shock Cardiogenic Middle Aged Risk Assessment Electrocardiography Death Sudden Cardiac Retreatment Humans Female Angina Unstable France Hospital Mortality Prospective Studies Registries Angioplasty Balloon Coronary Aged |
| Zdroj: | Europe PubMed Central |
| Popis: | The guidelines of the European Society of Cardiology, published in 2003, consider primary angioplasty as the preferred treatment strategy in acute coronary syndromes with ST-segment elevation, if the procedure can be performed within 90 min after first medical contact. We report the experience of three Alsacian centers running a common prospective registry with 2504 consecutive patients enroled between January 1999 and December 2004. The average age of the patients was 62 years with a proportion of 24% women. The time delay "pain to admission" wasor =3 hours in 55.9% of the cases. The treatment delay "door to catheterisation needle" was 59 min and the mean delay "door-to-reperfusion" was 79 min. The study population was representative of the real world including subsets of patients with a particulary high risk profile: ageor =70 years in 33%, a Killip gradeor =3 in 11.5%, rescucitated sudden death in 6.6% and cardiogenic shock in 10.9% of the patients respectively. The immediate procedural success rate (Timi 3 flow) in the treated coronary artery was 96.5%. The overall inhospital mortality-rate was 9.3%. The combinations of rescucitated sudden death--cardiogenic shock or ageor =75 years--cardiogenic shock were associated with a poor clinical outcome and mortality rates of 69% and 72.6% respectively, where as in the absence of abovementioned clinical high risk settings, the mortality rate was as low as 1.4%. The overall bleeding complication rate was 1.4%. The policy of systematic primary angioplasty in acute coronary syndromes with ST-Segment elevation appears to be coherent. The procedural complications and the in-hospital mortality rates were low, except in the presence of above mentioned clinical high risk settings. |
| Databáze: | OpenAIRE |
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