Pranas Šerpytis, Vytautas Abraitis, Vaidas Bilkis, Robertas Katliorius, Aistė Žebrauskaitė, Vida Žvironaitė, Egidijus Berūkštis

Abstract

The Aim of the research: To describe the factors which determine mortality rate in patients with acute miocardial infarction treated with percutaneous coronary intervention.
Methodology: Investigative scientific research is described. We have done retrospective analysis of 1043 patients case historys. We have analysed patients with acute ST wave elevation miocardial infarction, which were treated with percutaneous coronary intervention in Vilnius University Hospital Santariskiu Clinics Cardiac intensive care unit between 2008-2011. Patients were analysed by these data: age, gender, chronical diseases (arterial hypertension, dislypidemia, diabetes mellitus), if they had myocardial infarction before, smoking habits, if thrombolysis was done in primary hospital, before hospitalysing in Santariskiu Clinics. The one year mortality rate after percutaneous coronary intervention was followed. Was made the analysis how the time of percutaneous coronary intervention dispencing was relative with patients mortality. Patients were separated in two groups. I group of patients witch had thrombolysis and pecutaneous coronary intervention, II group was treated only with coronary percutaneous intervention.
Results of the Research: In the I-st group were 201 patients – 148 (73,6%) man, 53 (26,4%) women, mean patients age was 64 (±12) years. In the II-nd group were 842 patients – 593 (70,4%) man and 249 (29,6%) women, mean patients age was 64 (±12) years. Mortality rate in the I group was 5,5%, in the II-nd – 7,6%. In both groups were higher number of man. In both groups higher mortality rate was in: women (p<0,05), patients with arterial hypertension (p<0,05), older than 75 years (p<0,05). In the I group mortality rate was higher in patients with dislypidemia (p<0,05). In the II group mortality rate was higher in patients which have had a myocardial infarction before (p<0,05), with diabetes mellitus (p<0,05); In patients to whom PCI was later than 90 minutes from arrival in to PCI hospital (p<0,05). Mortality rate was smaller in patients treated with thrombolysis and PCI than in patients treated only wityh PCI (5,5% vs. 6,5%) (p<0,05).
Conclusions: patients mortality rate is concerned with older age, female gender and chronical diseases (arterial hypertension, diabetes mellitus). Early done reperfusion therapy (thrombolysis or percutaneous coronary intervention) improve patient survival rate. Patients, which were presented in to a non-percutaneous coronary intervention hospital, survival rate is beter, if thrombolysis is done before moving them in to percutaneous coronary intervention hospital. Patients with rescue percutaneous coronary intervention have higher mortality rate than patients with primary percutaneous coronary intervention or than patients with percutaneous coronary intervention done after thrombolytic therapy.
The loading 600 mg Clopidogrel dose reduces the mortality more than 300 mg dose. Bleeding complications 30 days after percutaneous coronary intervention increase patients one year mortality.

Article in Lithuanian

doi:10.5200/sm-hs.2012.105

Keyword(s): ST wave myocardial infarction; mortality rate; percutaneous coronary intervention
DOI: 10.5200/350
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