Two years mortality in patients with myocardial infarction in our center that can not be done interventional therapy

Objective: The study was aimed to examine clinical and demographic characteristics, in-hospital and two years mortality of 92 patients hospitalized for acute myocardial infarction (MI) between January 2005-December 2005 in our hospital that can not made invasive therapy.
Methods: Records of patients were reviewed retrospectively. Two years moratlitiy was taken about by calling phone. For statistical evaluations, SPSS 16.0 for Windows software was used.
Results: Mean age of 92 patients was 58.1±10.14 years. Seventy-three of the patients were male and 19 were female. Non-ST elevation MI was found in 8 (9%) patients and ST-elevation MI in 84 (91%). Forty one (4%%) patients received thrombolytic treatment, 51 (65%) did not due to reaching to the hospital lately or several counter indication. Seventeen patients died at admission. In-hospital mortality rate is significantly lower in patients receiving thrombolitic (p=0.045). Thirty-three patients developed complication at admission. The most frequent complication was cardiogenic shock. In two years after discharcing th patients; two years moratlity was significantly lower in patients receiving thrombolitic (p<0,05). There was no difference in new ACS between two groups.
Conclusion: Although cardiovascular death is the most common cause of death, a few centers in our country are able to perform interventions in acute coronary syndromes. This increases the importance of centers performing thrombolytic treatment such as our one. In the current study, a substantial proportion of patients did not receive thrombolytic treatment due to delayed admission to the hospital.In hospital and two years mortality was significantly lower among those receiving thrombolytic treatment. Hence, the community should be appropriately informed to allow the early admission to the hospital.

Giriþimsel tedavi olanaðý olmayan merkezimizde miyokard infarktüslü hastalarýn 2 yýllýk mortalite oranlarý

Amaç: Giriþimsel tedavi imkaný olmayan merkezimizde Ocak 2005-Aralýk 2005 arasýnda Akut myokard infarktüsü (MI) tanýsýyla hospitalize edilen 92 hastanýn klinik, demografik özellikleri, hastane içi ve 2 yýllýk mortalite oranlarýnýn incelenmesi amaçlanmýþtýr.
Yöntem: Hastalarýn kayýtlarý geriye dönük incelendi. 2 yýllýk mortalite bilgisi hastalar telefonla aranarak edinildi. Ýstatistik deðerlendirmelerde SPSS 16.0 for Windows programý kullanýldý.
Bulgular: 92 hastanýn yaþ ortalamasý 58.1±10.14 idi. Hastalarýn 73’ü erkek, 19’u bayan idi. Sekiz hastada ST elevasyonsuz MI, 84 (%91) hastada ST elevasyonlu MI tespit edildi. 41 hastaya (%45) trombolitik tedavi uygulanmýþ, 51 (%65)’ine hastaneye geç ulaþmalarý yada kontrendikasyon bulunmasý nedeniyle trombolitik uygulanmamýþtýr. 17 (%18.4) hastada yatýþý sýrasýnda ölüm gerçekleþmiþtir. Trombolitik uygulanan hastalarda hastane içi mortalite anlamlý derecede düþüktür (p: 0.045). 33 hastada yatýþý sýrasýnda komplikasyon geliþmiþtir. En sýk kardiyojenik þok gözlenmiþtir. Hastalar taburcu olduktan sonraki iki yýllýk dönemde; trombolitik uygulanan ve uygulanmayan grup arasýnda AKS tekrarý açýsýndan fark olmamasýna karþýn;trombolitik uygulanan hastalarda mortalite anlamlý derecede düþüktür (p<0,05).
Sonuç: Kardiyovasküler ölümler mortalitenin en sýk sebebi olmasýna karþýn, ülkemizde akut koroner sendromlarda giriþim yapabilecek merkez sayýsý azdýr. Bu durum merkezimiz gibi trombolitik tedavi yapan merkezlerin önemini arttýrmaktadýr. Çalýþmamýzda hastalarýn önemli bir kýsmýna hastaneye geç baþvurmalarý nedeniyle trombolitik uygulanamamýþtýr. Hastane içi ve 2 yýllký mortalite trombolitik uygulananlarda anlamlý derecede düþüktür. Bu nedenle toplumun doðru bilgilendirilerek hastaneye erken baþvurulmasý saðlanmalýdýr.