Changes in Acute Coronary Syndrome Treatment and Prognosis After Implementation of the Infarction Code in a Hospital With a Cardiac Catheterization Unit
Por:
Cordero A, Lopez-Palop R, Carrillo P, Frutos A, Miralles S, Gunturiz C, Garcia-Carrilero M and Bertomeu-Martinez V
Publicada:
1 ago 2016
Categoría:
Cardiology and cardiovascular medicine
Resumen:
Introduction and objectives: Emergency care systems have been created to improve treatment and revascularization in myocardial infarction but they may also improve the management of all patients with acute coronary syndrome.
Methods: A comparative study of all patients admitted with acute coronary syndrome before and after implementation of an infarction protocol.
Results: The study included 1210 patients. While the mean age was the same in both periods, the patient group admitted after implementation of the protocol had a lower prevalence of diabetes mellitus and hypertension but more active smokers and higher GRACE scores. The percentage of ST-segment elevation acute coronary syndrome (29.8%-39.5%) and coronary revascularizations (82.1%-90.1%) significantly increased among patients admitted with acute coronary syndrome, and primary angioplasty became routine (51.9%-94.9%); there was also a reduction in time to catheterization and an increase in early revascularization. The mean hospital stay was significantly shorter after implementation of the infarction protocol. In-hospital mortality was unchanged, except in high-risk patients (38.8%-22.4%). After discharge, no differences were observed between the 2 periods in cardiovascular mortality, all-cause mortality, reinfarction, or major cardiovascular complications.
Conclusions: After implementation of the infarction protocol, the percentage of patients admitted with ST-segment elevation acute coronary syndrome and the mean GRACE score increased among patients admitted with acute coronary syndrome. Hospital stay was reduced, and primary angioplasty use increased. In-hospital mortality was reduced in high-risk patients, and prognosis after discharge was the same in both periods. (C) 2016 Sociedad Espanola de Cardiologia. Published by Elsevier Espana, S.L.U. All rights reserved.
Filiaciones:
:
Departamento de Cardiología, Hospital Universitario de San Juan, San Juan de Alicante, Alicante, Spain
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Departamento de Cardiología, Hospital Universitario de San Juan, San Juan de Alicante, Alicante, Spain
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Departamento de Cardiología, Hospital Universitario de San Juan, San Juan de Alicante, Alicante, Spain
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Departamento de Cardiología, Hospital Universitario de San Juan, San Juan de Alicante, Alicante, Spain
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Departamento de Cardiología, Hospital Universitario de San Juan, San Juan de Alicante, Alicante, Spain
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Departamento de Cardiología, Hospital Universitario de San Juan, San Juan de Alicante, Alicante, Spain
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Departamento de Cardiología, Hospital Universitario de San Juan, San Juan de Alicante, Alicante, Spain
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Departamento de Cardiología, Hospital Universitario de San Juan, San Juan de Alicante, Alicante, Spain
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