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Hospital Pharmacology - International Multidisciplinary Journal
2016, vol. 3, br. 3, str. 454-462
jezik rada: engleski
vrsta rada: originalan članak
objavljeno: 13/01/2017
doi: 10.5937/hpimj1603454R
Creative Commons License 4.0
Klinički i laboratorijski parametri ranog mortaliteta bolesnika sa akutnim infarktom miokarda lečenih primarnom perkutanom koronarnom intervencijomi
aOpšta bolnica Valjevo, Odeljenje interne medicine - kardiologija, Valjevo
bKlinički centar Srbije, Klinika za kardiologiju, Beograd

e-adresa: igormrd@gmail.com

Sažetak

Uvod: Primarna perkutana koronarna intervencija (pPCI) postala je najvažnija strategija u reperfuziji pacijenata sa ST- elevacijom u infarktu miokarda (STEMI). Dosadašnje studije su pokazale da se određeni klinički i laboratorijski parametri mogu povezati sa ranim mortalitetom kod pacijenata sa akutnim infarktom miokarda lečenih primarnom PCI. Cilj: Cilj našeg istraživanja bio je da se procene klinički i laboratorijski pokazatelji rane nepovoljne prognoze naših pacijenata sa STEMI, a koji su lečeni primarnom PCI. Materijal i metode: Populacija naše IV faze, akademske, opservacione, retrospektivne studije preseka, obuhvata ukupno 180 uzastopnih pacijenata (128 muškaraca i 52 žene), starosti od 18 godina i više, a koji su ispoljili kliničke i elektrokardiografske znake akutnog STEMI u roku od 12 sati nakon pojave simptoma. Analizirali smo parametre koji su registrovani u sistemu baze podataka koronarne jedinice Urgentnog centra. Rezultati: Prosečna starost preživelih pacijenata bila je 58 ± 11 godina i 67 ± 9 godina u grupi umrlih pacijenata, iako razlika između grupa nije bila statistički značajna (p = 0.075). U grupi pacijenata koji nisu preživeli bilo je značajno više hipotenzije na prijemu (p = 0.015) i akutnog bloka grane na EKG-u (p = 0.032), kreatinin je bio viši na prijemu (p = 0.036), kao i veća učestalost hiperlipidemije (p = 0.044) i klirensa kreatinina ispod 60 ccs / min (p < 0,001), zatim češća je bila pojava Killip > 1 srčane insuficijencije na prijemu (p = 0.038), ali je učestalost pušača bila značajno manja (p = 0.021). Prediktori ranog nepovoljnog događaja u multivarijantnoj analizi bili su: akutni blok grane, dijabetes, Killip>1 na prijemu, hipotenzija na prijemu i klirens kreatinina ispod 60 ccs / min. Zaključak: Naša studija je pokazala da akutni blok grane, dijabetes, Killip>1 srčane insuficijencije na prijemu, hipotenzija na prijemu, kao i klirens kreatinina ispod 60 ccs / min, predstavljaju nezavisne kliničke i laboratorijske prediktore ranog mortaliteta kod pacijenata sa STEMI lečenih primarnom PCI.

Ključne reči

PCI; infarkt miokarda; rani mortalitet

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