TRANSPORT OF PATIENTS FOR PRIMARY PTCA FROM GENERAL HOSPITAL NOVO MESTO TO LJUBLJANA
Abstract
Background. The treatment of acute coronary syndrom (ACS) with ST-segment elevation with primary percutaneous transluminal coronary angioplasty (PTCA) has been a routine method for treatment of these patients in KC Ljubljana since April 2000. Using this method, mortality due to ACS, reinfarction, total number of death and strokes in comparison to thrombolytic therapy were highly reduced. Since May 2001 primary PTCA has been attainable also for patients from regional hospitals to be transferred quickly enough to Ljubljana.
Methods. A retrospective analysis of patients with ACS with ST-segment elevation who have been transferred from General Hospital Novo mesto to KC Ljubljana in the period from Oct. 1, 2001 to March 31, 2002 to have a primary PTCA was performed. The analysis comprised the following: time interval from the chest pain start to the arrival of patient to the General Hospital Novo mesto, handling of patient at Internistic department of General Hospital Novo mesto, transport of patient to Ljubljana and total time interval from the arrival of patient to the first inflation of balloon in Ljubljana.
Results. In the upper mentioned period 14 patient (12 males and 2 females) were transported from the General Hospital Novo mesto to the KC Ljubljana to perform a primary PTCA. Our patients arrive to hospital very late. Due to problems with transport organisation and patient’s escort and duty, total time interval measured between the patient arrival to the General Hospital Novo mesto to the first inflation of balloon in Ljubljana was 2h and 42 minutes. That was longer that had been stated previously in the literature.
Conclusions. In our opinion, primary PTCA is practicable also for patients admitted to a regional hospital because of ACS with ST-segment elevation. The transport of patient is safe. Better organisation of Health Service and patient transportion would shorten the time needed to perform the first inflation of balloon in Ljubljana.
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References
Noč M, Kranjec I, Remškar M. Priporočila za obravnavo bolnikov z akutnim koronarnim sindromom v Sloveniji. Simpozij akutni koronarni sindrom v Sloveniji. Bled 2002: Ljubljana: Združenje kardiologov Slovenije, 2002: 1– 35.
Widimsky P, Groch L, Zelizko M, Aschermann M et al. Multicentre randomized trial comparing transport to primary angioplasty vs. immediate thrombolysis vs. combined strategy for patients with acute myocardial infarction presenting to a community hospital without a catheterization laboratory. The PRAGUE study. Eur Heart J 2000; 21: 823–31.
Ostergard T, Martin G, Sorensen EV. Transportation of patients with acute myocardial infarction. Ugeskr Laeger 2000; 162: 2558–60.
Andreassen AK, Nanbjor A, Endresen K, Offstad J. Angioplasty in acute myocardial infarction in patients transferred from other hospital. Tidsskr Nor Laegeforen 2001; 121: 2933–7.
ACC/AHA. 1999 update guidelines for the management of patient with acute myocardial infarction: Executive summary and recommendations. Circulation 1999; 100: 1016–30.
Noč M, Kranjec I, Remškar M. Akutni koronarni sindrom – predlog priporočil za obravnavo v Sloveniji. Zdrav Vestn 2002; 71: 317–26.
Kapš R. Prehospitalno obdobje bolnikov z akutnim miokardnim infarktom na novomeškem območju. Zdrav Vestn 1988; 57: 215–8.
Remškar M, Jazbec A, Horvat M, Noč M. Zdravljenje bolnikov z akutnim srčnomišičnim infarktom. Zdrav Vestn 2001, 70: 133–7.
Stone GW, Grines CL, Cox DA et al. for the CADILLAC Investigators. Comparison of angioplasty with stenting, with or without abciximab, in acute myocardial infarction. N Engl J Med 2002; 346: 957–66.
Andersen HR. The Danish multicenter randomized trial on thrombolytic therapy vs. acute coronary angioplasty in acute myocardial infarction. Heart Wire News 2002: March 20.
Anon. Thrombolytic therapy vs. primary percutaneous coronary intervention for myocardial infarction in patients presenting to hospitals without on-site cardiac surgery (C-PORT). JAMA 2002; 287: 1943–51.
Zijlstra F, Patel A, Jones M et al. (for the PCAT collaboration). Clinical characteristics and outcome of patients with early (< 2 h), intermediate (2– 4 h) and late (> 4 h) presentation treated by primary coronary angioplasty or thrombolytic therapy for acute myocardial infarction. Eur Heart J 2002; 23: 550–7.
Grines CL, Westerhausen DR, Grines LL et al. (for the Air Primary Angioplasty in Myocardial Infarction Study). A randomized trial of transfer for primary angioplasty versus on-site thrombolysis in patients with high-risk myocardial infarction. JACC 2002; 39: 1713–22.
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