H. Shrestha, R. Gajurel, C. Poudel, S. Thapa, A. Sayami
{"title":"三级医疗中心急性ST段抬高型心肌梗死的短期疗效","authors":"H. Shrestha, R. Gajurel, C. Poudel, S. Thapa, A. Sayami","doi":"10.3126/JIOM.V42I3.37570","DOIUrl":null,"url":null,"abstract":"Introduction Acute ST Elevation Myocardial infarction (STEMI) is a cardiovascular emergency and is associated with significant adverse short and long-term outcome. The objective of this study was to determine the shortterm outcome in terms of heart failure, myocardial reinfarction, stroke, hospital readmission and mortality in patients admitted with STEMI Methods It was a prospective observational study conducted at Manmohan Cardiothoracic Vascular and Transplant Center, Kathmandu from May 2014 to April 2015. All patients admitted with diagnosis of STEMI during study period were enrolled. Patients were treated on the basis of existing guidelines. Mode of management, adverse outcomes and mortality of patients during the study period were evaluated. The discharged patients were followed up for 30 days. Statistical analysis was performed with SPSS version 20. Ethical approval was taken from the Institutional Review Committee of Institute of Medicine. Results The median duration of presentation was 20 hours, and only 40% of the patients presented within 12 hours of symptom onset. Primary PCI was performed in 50 (33%), thrombolysis was performed in 29(19%) and conservative medical management was done in 72 (48%) patients. Overall outcome occurred in 52 (37.7%) patients. In hospital and 30 day mortality was 14 (9.2%) and 17 (11%) respectively. Heart failure was present in 28(18.5%), myocardial reinfarction 8 (5%), stroke 4 (2.6%), and hospital readmission was 18 (12%). Conservatively treated patients had significantly more adverse outcomes (p=0.02). More patients in conservatively managed group had hospital readmission. (p=0.04) Conclusion There were more overall adverse outcomes in conservatitley managed group which is mainly due to more hospital readmission.","PeriodicalId":85033,"journal":{"name":"Journal of the Institute of Medicine","volume":"42 1","pages":"12-17"},"PeriodicalIF":0.0000,"publicationDate":"2020-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"1","resultStr":"{\"title\":\"Short Term Outcome of Acute ST Elevation Myocardial Infarction in a Tertiary Care Cardiac Center\",\"authors\":\"H. Shrestha, R. Gajurel, C. Poudel, S. Thapa, A. Sayami\",\"doi\":\"10.3126/JIOM.V42I3.37570\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Introduction Acute ST Elevation Myocardial infarction (STEMI) is a cardiovascular emergency and is associated with significant adverse short and long-term outcome. The objective of this study was to determine the shortterm outcome in terms of heart failure, myocardial reinfarction, stroke, hospital readmission and mortality in patients admitted with STEMI Methods It was a prospective observational study conducted at Manmohan Cardiothoracic Vascular and Transplant Center, Kathmandu from May 2014 to April 2015. All patients admitted with diagnosis of STEMI during study period were enrolled. Patients were treated on the basis of existing guidelines. Mode of management, adverse outcomes and mortality of patients during the study period were evaluated. The discharged patients were followed up for 30 days. Statistical analysis was performed with SPSS version 20. Ethical approval was taken from the Institutional Review Committee of Institute of Medicine. Results The median duration of presentation was 20 hours, and only 40% of the patients presented within 12 hours of symptom onset. Primary PCI was performed in 50 (33%), thrombolysis was performed in 29(19%) and conservative medical management was done in 72 (48%) patients. Overall outcome occurred in 52 (37.7%) patients. In hospital and 30 day mortality was 14 (9.2%) and 17 (11%) respectively. Heart failure was present in 28(18.5%), myocardial reinfarction 8 (5%), stroke 4 (2.6%), and hospital readmission was 18 (12%). Conservatively treated patients had significantly more adverse outcomes (p=0.02). More patients in conservatively managed group had hospital readmission. (p=0.04) Conclusion There were more overall adverse outcomes in conservatitley managed group which is mainly due to more hospital readmission.\",\"PeriodicalId\":85033,\"journal\":{\"name\":\"Journal of the Institute of Medicine\",\"volume\":\"42 1\",\"pages\":\"12-17\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2020-12-31\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"1\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of the Institute of Medicine\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.3126/JIOM.V42I3.37570\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of the Institute of Medicine","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.3126/JIOM.V42I3.37570","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 1
摘要
急性ST段抬高型心肌梗死(STEMI)是一种心血管急症,具有显著的短期和长期不良预后。本研究的目的是确定STEMI患者在心力衰竭、心肌再梗死、卒中、再入院和死亡率方面的短期结局。这是一项前瞻性观察性研究,于2014年5月至2015年4月在加德满都的曼莫汉心胸血管和移植中心进行。所有在研究期间被诊断为STEMI的患者被纳入研究。患者是根据现有的指导方针进行治疗的。评估研究期间患者的管理模式、不良结局和死亡率。出院患者随访30 d。采用SPSS version 20进行统计分析。伦理批准由医学研究所的机构审查委员会。结果中位出现时间为20小时,只有40%的患者在症状出现后12小时内出现。50例(33%)患者接受了首次PCI治疗,29例(19%)患者接受了溶栓治疗,72例(48%)患者接受了保守治疗。52例(37.7%)患者出现了总体结果。住院和30天死亡率分别为14例(9.2%)和17例(11%)。心衰28例(18.5%),心肌再梗死8例(5%),卒中4例(2.6%),再入院18例(12%)。保守治疗的患者不良结局显著增加(p=0.02)。保守治疗组患者再入院率较高。(p=0.04)结论保守治疗组总体不良事件发生率较高,主要原因是再入院率较高。
Short Term Outcome of Acute ST Elevation Myocardial Infarction in a Tertiary Care Cardiac Center
Introduction Acute ST Elevation Myocardial infarction (STEMI) is a cardiovascular emergency and is associated with significant adverse short and long-term outcome. The objective of this study was to determine the shortterm outcome in terms of heart failure, myocardial reinfarction, stroke, hospital readmission and mortality in patients admitted with STEMI Methods It was a prospective observational study conducted at Manmohan Cardiothoracic Vascular and Transplant Center, Kathmandu from May 2014 to April 2015. All patients admitted with diagnosis of STEMI during study period were enrolled. Patients were treated on the basis of existing guidelines. Mode of management, adverse outcomes and mortality of patients during the study period were evaluated. The discharged patients were followed up for 30 days. Statistical analysis was performed with SPSS version 20. Ethical approval was taken from the Institutional Review Committee of Institute of Medicine. Results The median duration of presentation was 20 hours, and only 40% of the patients presented within 12 hours of symptom onset. Primary PCI was performed in 50 (33%), thrombolysis was performed in 29(19%) and conservative medical management was done in 72 (48%) patients. Overall outcome occurred in 52 (37.7%) patients. In hospital and 30 day mortality was 14 (9.2%) and 17 (11%) respectively. Heart failure was present in 28(18.5%), myocardial reinfarction 8 (5%), stroke 4 (2.6%), and hospital readmission was 18 (12%). Conservatively treated patients had significantly more adverse outcomes (p=0.02). More patients in conservatively managed group had hospital readmission. (p=0.04) Conclusion There were more overall adverse outcomes in conservatitley managed group which is mainly due to more hospital readmission.