Criteria of patients management with acute myocardial infarction undergoing primary angioplasty

In recent decades, the cornerstone of modern treatment of acute myocardial infarction is an emergency reperfusion of the myocardium with primary angioplasty. Aim: The aim of the present study was to evaluate the characteristics of the selection criteria, treatment with primary angioplasty and outcome of patients after acute myocardial infarction. Material and Method: The studied sample consisted of 209 patients who underwent primary angioplasty after acute myocardial infarction. For data collection a special form was used which was modeled on the needs of the study. Statistical analysis was performed using the statistical package SPSS ver.19. Results: The studied population consisted of 209 patients, of which 82.8% (n = 173) were men. The mean age of study population was 58.8 years with a standard deviation of ± 13.1. The initial diagnostic criteria which lead to the call of the catheterization laboratory and the performance of the primary angioplasty refered on the main symptoms in 76.1% (n = 159) of patients a precordial pain and dyspnea in 23.9%. Relative to the introductory diagnostic electrocardiographic criteria related to the 41.6% (n = 87) was STEMI, the 41.6% (n = 87) lower STEMI, the 7.7% (n = 16) lateral STEMI, 2.4% (n = 5) and posterior STEMI with repolarization abnormalities featured in 6,7% (n = 14). Shock developed 4.3% (n = 9) of the sample. According to the criteria, upon the detection of the biochemical heart indicators there was a significant increase on the prices of the sample checked during its admittance on the ED. The prices kept on rising even on samples which were taken 4h later. No statistically significant difference between patients who attended the ED on "operating hours" to those who proceed in "out of hours", in terms of outcome. A statistical significance was found between patients who were in shock in relation to those who were stable as far as their outcome is concerned. Conclusions: For proper and early diagnosis of acute myocardial infarction, clinical, electrocardiographic and biochemical criteria are essential. The specific criteria contribute to the rapid activation of the hemodynamic laboratory and as a result the achievement of the primary angioplasty and it seems that 24 hour availability of hospitals is an important factor for patients' health outcome

Keywords: Acute myocardial infarction, catheterization laboratory, primary angioplasty, outcome