O Seu Saber Ocupa um Lugar! DSpace

Repositório Comum >
HB - Hospital de Braga >
HB - Cardiologia >
HB - CAR - Artigos >

Please use this identifier to cite or link to this item: http://comum.rcaap.pt/handle/123456789/1799

Título: Preditores de demora pré-hospitalar em doentes com enfarte agudo do miocárdio com elevação do segmento ST
Outros títulos: Predictors of pre-hospital delay in patients with ST-segment elevation myocardial infarction
Autor: Ribeiro, S
Gaspar, A
Rocha, S
Nabais, S
Azevedo, P
Salgado, A
Pereira, MA
Correia, A
Palavras-chave: Enfarte do Miocárdio
Issue Date: 2010
Editora: Sociedade Portuguesa de Cardiologia
Citação: Rev Port Cardiol. 2010;29(10):1521-32.
Resumo: BACKGROUND: Early reperfusion therapy in ST-elevation myocardial infarction (STEMI) correlates with its success. The aim of our study was to characterize patients admitted with a diagnosis of STEMI with longer prehospital delay and to analyze its impact on the choice of treatment and on in-hospital prognosis. METHODS: We performed a retrospective cohort study of 797 patients consecutively admitted with a diagnosis of STEMI from January 2002 to December 2007. The cutoff for longer pre-hospital delay was defined as three hours. We analyzed demographic, clinical and echocardiographic data and determined the predictors of pre-hospital delay of > or = 3 h. RESULTS: Of the 797 patients, 77% were male and mean age was 62 +/- 13.64 years. Patients with longer pre-hospital delay were older (p < 0.001), with a higher proportion of female (p = 0.001), hypertensive (p = 0.002), diabetic (p < 0.001), and surgically revascularized patients (p = 0.007), and those with symptom onset between 10 pm and 8 am (p = 0.001). The group with shorter pre-hospital delay included more men (p = 0.001), patients with prior myocardial infarction (p = 0.025) and smokers (p = 0.009). Independent predictors of pre-hospital delay of 3 h included female gender (odds ratio [OR] 1.5, 95% confidence interval [CI] 1.03-2.16), diabetes (OR 1.78, 95% CI 1.23-2.56), systemic arterial hypertension (OR 1.41, 95% CI 1.04-1.93), and symptom onset between 10 pm and 8 am (OR 1.76, 95% CI 1.31-2.38). Independent predictors of pre-hospital delay of > or = 3 h included male gender (OR 0.67, 95% CI 0.46-0.97) and prior myocardial infarction (OR 0.48, 95% CI 0.27-0.84). Reperfusion therapy was performed in 72%, 52% and 12% of patients with pre-hospital delay of <3 h, 3-12 h and >12 h, respectively (p for trend <0.001). Patients with longer delay more often had severely reduced left ventricular ejection fraction (LVEF) (p = 0.004). A non-significant trend was observed towards increased in-hospital mortality with longer delay (8.3% vs. 6.6%, p for trend = 0.342). CONCLUSIONS: A significant proportion of patients continue to have long pre-hospital delay. Female patients and those with diabetes, systemic arterial hypertension and symptom onset between 10 pm and 8 am made up the majority of this group. Longer pre-hospital delay was associated with a lower probability of being treated with reperfusion therapy, a higher frequency of severely depressed LVEF and a non-significant increase in in-hospital mortality. It is essential to develop mechanisms to reduce pre-hospital delay.
Arbitragem científica: yes
URI: http://comum.rcaap.pt/handle/123456789/1799
Appears in Collections:HB - CAR - Artigos

Files in This Item:

File Description SizeFormat
Predictors of pre-hospital delay in patients with ST-segment elevation myocardial infarction.pdf138,65 kBAdobe PDFView/Open
FacebookTwitterDeliciousLinkedInDiggGoogle BookmarksMySpaceOrkut
Formato BibTex mendeley Endnote Logotipo do DeGóis 

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.


Estamos no RCAAP Governo Português separator Ministério da Educação e Ciência   Fundação para a Ciência e a Tecnologia

Financiado por:

© 2009 - REPOSITÓRIO COMUM - Comentários - Statistics