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ISSN 2594-3006 (Electronic)
ISSN 2007-1752 (Print)
Archivos de Medicina de Urgencia de México

2010, Number 1

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Arch Med Urg Mex 2010; 2 (1)

Survival to thirty days to patients with acute myocardial infarction non trombolized, attended in the Emergency Service of the second level

Hernández-Pérez F

Language: Spanish
References: 30
Page: 17-24
PDF size: 164.64 Kb.


ABSTRACT

Objective: To determine the survival of heart attack and angina thirty days in patients with acute myocardial infarction who were not thrombolized compared patients who received therapy with thrombolytics. Material and methods: A cohort study to 30 days in patients with acute myocardial infarction in two general hospitals during the period of over two years. It included all patients who were admitted with the diagnosis of acute myocardial infarction or that operate within the Emergency Department. We excluded patients who had been diagnosed and treated at another hospital and were removed to have died of causes not related to infarction, while in the hospital or during the 30 days of follow-up. Was considered acute myocardial infarction if they had two or more criterions when their arrived to hospital; chest pain or equivalent ischemic origin, presence of neurovegetative symptoms, electrocardiographic changes and enzyme elevation. We evaluated the presence of angina, death or new myocardial infarction during their hospital stay and for 30 days. Statistical analysis: Percentages were used for descriptions of demographic variables and the χ2 for the analysis of percentages (with Fisher exact test where appropriate). For the analysis of continuous variables used the Student t-test and assessed the relative risk (RR) for the risk of death, angina and myocardial infarction. Results: We included 74 patients, of whom one was eliminated by loss to follow up. Of 73 patients 38 patients were thrombolized and 35 not, of whom 56 were men (76.7%) and 17 women (23.3%) with a mean age of 59.18 ± 13.6 years (minimum 26 and maximum 89 years). Average time of onset of pain and arrival to hospital was 599.92 minutes with an average blood pressure of 124/76. Most patients were admitted with a Killip-Kimball functional class I in 70 patients (95.9%), II, 2 (2.7%) III, IV and 0, 1 (1.4%), 64 patients showed no arrhythmia. Were not thrombolized 35 (Group I) and 38 (Group II) received therapy thrombolytic; 19 were used tenecplasa, 12 rtPA and 7 with streptokinase. The mortality rate was 8.2% (11.4% in group I and group II 5.2%) without significant difference between groups (p = 0.298), there were no significant differences for age (p = 0.094), blood pressure, CK MB to arrive to hospital (p = 0.72 for TAS, 0821 for the TAD, CK and 0.36 for 0148 MB fraction). Only blood glucose was significantly higher in the group not thrombolized (203.7 vs 170.7 mg/dL, p = 0.005). There was a mortality of 6 patients (8.2%), the infarcted area was the most common inferior, all had 3 or more major risk factors for ischemic heart disease, and two patients were deceased thrombolized used tenecplasa. Conclusions: In this work, we found no significant differences in the presence of death, myocardial infarction or angina at 30 days in patients with acute myocardial infarction who were not thrombolized compared with patients who received therapy, thrombolytics.


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