| Title: |
An Overview of Care Changes in the Last 6 Year in Primary PCI in ST-Elevation Myocardial Infarction in a Tertiary University Brazilian Hospital |
| Authors: |
Machado, Guilherme Pinheiro, Pivatto Junior, Fernando, Wainstein, Rodrigo, Araujo, Gustavo Neves de, Carpes, Christian Kunde, Lech, Mateus Correa, Valle, Felipe Homem, Bergoli, Luiz Carlos Corsetti, Gonçalves, Sandro Cadaval, Wainstein, Marco Vugman |
| Source: |
International Journal of Cardiovascular Sciences. April 2019 32(2) |
| Publisher Information: |
Sociedade Brasileira de Cardiologia, 2019. |
| Publication Year: |
2019 |
| Subject Terms: |
Mocardial Infarction/mortality, Percutaneous Coronary Intervention, Mortality, Shock, Cardiogenic |
| More Details: |
Background: Although new studies and guidelines can be considered useful tools, it does not necessarily mean they are put into clinical practice. Objective: The aim of the current analysis was to assess the changes in primary percutaneous coronary intervention (PCI) and mortality in a tertiary university hospital in southern Brazil during a six-year period. Methods: We have included consecutive patients with ST-elevation myocardial infarction (STEMI) who underwent primary PCI between March 2011 and February 2017. Previous clinical history, characteristics of the procedure, and reperfusion strategies were collected. In-hospital, short and long-term mortalities were also evaluated. The significance level adopted for all tests was 5%. Results: There was an increase in the use of radial access in patients from 20.0% in 2011 to 62.7% in 2016 (ptrend < 0.0001). Moreover, thrombus aspiration decreased significantly from 66.7% in 2011 to less than 3.0% in 2016 (ptrend < 0.0001). In-hospital, short and long-term mortalities remained reasonably stable from 2011 to 2016 (ptrend > 0.05). However, a lower in-hospital mortality was observed in patients treated through radial access (p < 0.001). Cardiogenic shock occurred in 11.1%, without statistical differences in the period (ptrend = 0.39), while long-term mortality rate decreased from 80.0% in 2011 to 27.3% in 2016 in this patient group (ptrend = 0.29). Conclusions: During a 6-year follow-up period, primary PCI characteristics underwent important modifications. Radial access became widely used, with a decrease in mortality with the use of this route, while aspiration thrombectomy became a rare procedure. The incidence of cardiogenic shock remained stable, but has shown a reduction in its mortality. |
| Document Type: |
article |
| File Description: |
text/html |
| Language: |
English |
| ISSN: |
2359-5647 |
| DOI: |
10.5935/2359-4802.20180090 |
| Access URL: |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S2359-56472019000200125 |
| Rights: |
info:eu-repo/semantics/openAccess |
| Accession Number: |
edssci.S2359.56472019000200125 |
| Database: |
SciELO |
