ST Segment Yükselmeli Miyokard İnfarktüsü ile Başvuran Hastalarda Hastane İçi ve Uzun Dönem Mortalitenin Değerlendirilmesi: Üçüncü Basamak Kardiyoloji Merkezi Deneyimi

Abstract

Amaç: İskemik kalp hastalığı tüm dünyada önde gelen bir ölüm sebebidir ve kardiyovasküler hastalığı olan hastalarda yaşam beklentisini uzatmak için sadece sağlık hizmeti sağlayıcılarının stratejileri değil, toplum özellikleri de önem arz etmektedir. Bu nedenle, ilgilenilen toplum özelliklerini yansıtan, ulusal, klinik çalışmalar gerçek yaşam sağlık hizmetleri hakkında önemli bilgiler vermektedir. Biz bu çalışma ile üçüncü basamak kardiyoloji merkezimize başvuran ST elevasyonlu miyokart enfarktüsü (STEMI) hastalarında hastane içi ve uzun dönem sonuçlarımızı değerlendirmeyi amaçladık. Gereç ve Yöntemler: Primer perkütan koroner girişim (PCI) ile tedavi edilen ve telefon ile yaptığımız sorgulamalara cevap veren veya takiplerinde vefat ettiği belgelenen toplam 178 STEMI hastası analizlere dâhil edildi. Bu hastalar yaşa göre üç gruba ayrıldı (Grup-1: <35 yaş, Grup-2: ≥35-60 yaş ve Grup-3: ≥ 60 yaş). Bu üç grup hastanın takiplerinde ki ölüm ve ölümcül olmayan kardiyovasküler istenmeyen olaylar mukayese edildi. Hayatta kalma eğrileri Kaplan-Meier yöntemi ile oluşturuldu. Bulgular: Çalışmamızda medyan takip süresi 95 aydı. Hastane içi dönemde, 4 hastada yeniden miyokart enfarktüsü ve 4 hastada ölüm görüldü. Uzun süreli takipte ise 30 hastada yeniden miyokart enfarktüsü izlendi. Tekrar miyokart enfarktüsü sıklığında gruplar arasında farklılık görülmedi. Çalışmaya dâhil edilen hastalarda uzun süreli mortalite % 27,5 olarak bulundu (n = 49). Gruplar arasındaki mortalite oranlarının anlamlı derecede farklı olduğu tespit edildi (sırasıyla; Grup-1 için % 13,3, Grup-2 için % 16, 8, Grup-3 için % 53,5) (p <0.001). Sonuç: STEMI ile başvuran ve primer PCI ile tedavi edilen hastalarda hastane içi ve uzun dönem sonuçlarının değerlendirildiği çalışmamızda 95 aylık takipte, tüm nedenlere bağlı mortalite % 27,5 olarak bulunmuştur.

Keywords

• ST elevasyonlu miyokart enfarktüsü
• uzun sureli sonuçlar
• mortalite
• hastane içi istenmeyen olay

Evaluation of Intra-hospital and Long-term Mortality in Patients Presenting with ST-segment Elevation Myocardial Infarction: A Tertiary Cardiology Center Experience

Abstract

Objective: Ischemic heart disease remains the leading cause of death. Not only strategies of health care providers but also population characteristics are also important to extend life expectancy in patients with cardiovascular disease. Thus clinical studies including national cohort of patients provide important insights into the real-life health care. We aimed to assess intra-hospital and long-term outcomes in patients with ST-elevation myocardial infarction (STEMI). Materials and Methods: A total of 178 STEMI patients treated with primary percutaneous coronary intervention (PCI), who were documented to be death or responded the telephone interview, were included into the analyses. These patients were divided into three groups according to age (Group-1: <35 years, Group-2: ≥35-60 years, and Group-3: ≥ 60 years). Mortality and nonfatal cardiovascular complications were compared in three groups. Results: Median period of follow-up was 95 months. At the intra-hospital period, re-myocardial infarction was occurred in 4 patients while death was seen in 4. During the long term follow-up, re-myocardial infarction was occurred in 30 patients. Incidence of re-myocardial infarction did not differ among the groups. Long-term mortality among study patients was found to be 27.5 % (n=49). The mortality rates between the groups were significantly different (13.3% for group-1, 16.8% for group-2, 53.5% for group-3, respectively) (p <0.001) Conclusion: In conclusion, the present study is an evaluation of intra-hospital and long-term outcomes in patients presented with STEMI and treated with primary PCI. Over the 95 months follow-up, all cause mortality was found to be 27.5% in those.

Keywords

• ST-elevation myocardial infarction
• long term outcome
• mortality
• intra-hospital complication

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