Delay factors on the administration of thrombolytic therapy in patients diagnosed with acute myocardial infarction in a general hospital

Muller, Luis Antonio; Rabelo, Eneida Rejane; Moraes, Maria Antonieta; Azzolin, Karina de Oliveira

doi:10.1590/s0104-11692008000100009

Cited by 10 publications

(9 citation statements)

References 9 publications

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“… 4 Evidence in the literature indicates that female gender, marital status, Diabetes Mellitus (DM), Systemic Arterial Hypertension (SAH), atrial fibrillation, and age are predictors of hospital arrival delay. 5 - 10 …”

Section: Introductionmentioning

confidence: 99%

Independent Predictors of Late Presentation in Patients with ST-Segment Elevation Myocardial Infarction

Rodrigues

Melleu

Schmidt

et al. 2018

Arquivos Brasileiros De Cardiologia

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BackgroundIn patients with acute ST-segment elevation myocardial infarction (STEMI), the time elapsed from symptom onset to receiving medical care is one of the main mortality predictors.ObjectiveTo identify independent predictors of late presentation in patients STEMI representative of daily clinical practice.MethodsAll patients admitted with a diagnosis of STEMI in a reference center between December 2009 and November 2014 were evaluated and prospectively followed during hospitalization and for 30 days after discharge. Late presentation was defined as a time interval > 6 hours from chest pain onset until hospital arrival. Multiple logistic regression analysis was used to identify independent predictors of late presentation. Values of p < 0.05 were considered statistically significant.ResultsA total of 1,297 patients were included, with a mean age of 60.7 ± 11.6 years, of which 71% were males, 85% Caucasians, 72% had a mean income lower than five minimum wages and 66% had systemic arterial hypertension. The median time of clinical presentation was 3.00 [1.40-5.48] hours, and approximately one-quarter of the patients had a late presentation, with their mortality being significantly higher. The independent predictors of late presentation were Black ethnicity, low income and diabetes mellitus, and a history of previous heart disease was a protective factor.ConclusionBlack ethnicity, low income and diabetes mellitus are independent predictors of late presentation in STEMI. The identification of subgroups of patients prone to late presentation may help to stimulate prevention policies for these high-risk individuals.

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Section: Introductionmentioning

confidence: 99%

Independent Predictors of Late Presentation in Patients with ST-Segment Elevation Myocardial Infarction

Rodrigues

Melleu

Schmidt

et al. 2018

Arquivos Brasileiros De Cardiologia

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“…Ao se comparar com aos estudos de Franco, que apresentou um intervalo de tempo médio de 2h55min ± 3h59min e Muller de 4h15min ± 2h7min (Franco et al, 2008;Muller et al, 2008). O presente estudo demonstrou que apenas 27 % dos pacientes receberam tratamento em até 4 horas e 71 % receberam tratamento acima deste intervalo.…”

Section: Discussionunclassified

Perfil epidemiológico de pacientes com infarto agudo do miocárdio na microrregião de Itajubá (Minas Gerais)

Blanco,

Candiotto,

Cortez

2023

RSD

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Introdução: Infarto Agudo do Miocárdio (IAM) é caracterizado como a morte celular e necrose no músculo cardíaco, resultante da evolução de uma isquemia aguda, sendo a maior causa de morte no mundo. Objetivo: Traçar o perfil dos pacientes internados com diagnóstico de Infarto Agudo do Miocárdio (IAM) no Hospital das Clínicas de Itajubá (HCI). Métodos: Realizou-se um estudo retrospectivo, transversal, com amostra definitiva de 48 pacientes com diagnóstico de IAM, internados na enfermaria de clínica médica no HCI, no período entre dezembro de 2020 a dezembro de 2021. Os dados foram coletados utilizando um formulário contendo: Parte I: dados sociodemográficos dos participantes da pesquisa (idade, sexo, escolaridade); Parte II: Dados clínicos (antecedentes pessoais, comorbidades, patologias, fatores de risco e tratamentos realizados). Resultados: Os resultados obtidos e analisados, foram: 66,67% do sexo masculino; 37,5% na faixa 60 - 69 anos; 67,74% hipertensos; 12,9% dislipidêmicos; 35,48% diabéticos; Caracterização de escolaridade: 2,08% analfabetos, 47,92% com primeiro grau incompleto, 14,58% ensino médio completo, 6,25% ensino médio incompleto e 8% concluíram ensino superior; Estilo de vida: 9,68% obesidade; 47,92% tabagistas e 12,5% etilistas. Conclusão: Este estudo ampliou o conhecimento no campo da investigação científica acerca do infarto agudo do miocárdio na microrregião de Itajubá, identificando dados passíveis de serem utilizados como base para estratégias de prevenção e, consequentemente, melhora da qualidade e expectativa de vida.

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“…Several cohort and case series demonstrated that Brazilian patients have a similar clinical profile to patients admitted worldwide (table 1). 15 – 17 Nonetheless, compared with data from randomised clinical trials and international cohorts, there is a striking time delay in presentation to the emergency department from onset of symptoms (median of 9–11 h of delay in public institutions) and a small percentage of assistance by prehospital ambulance 18. These factors partially contribute to a sicker population of patients admitted into coronary care units, with higher Killip classes and prevalence of cardiogenic shock 15 19.…”

Section: Management Of Acute Coronary Syndromesmentioning

confidence: 99%

Coronary artery disease in Brazil: contemporary management and future perspectives

Polanczyk

Ribeiro

2009

Heart

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Cardiovascular diseases are responsible for 32% of total mortality in Brazil, mostly due to cerebrovascular and coronary artery disease. Epidemiological and socio-economical factors play a pivotal role on the distribution, severity and management of coronary artery disease, and the burden is greater in the southeast and south regions of the country, with a higher mortality in low-income populations. The Brazilian healthcare structure is divided into two complementary systems-public and private-but 75% of the population is covered exclusively by the public system. Some Brazilian institutions offer state-of-the-art care to patients with acute and chronic coronary artery disease, but regional inequalities in medical care are still significant. National policies will have to be implemented to fight risk factors, to ensure primary prevention strategies, including assistance on drugs with known protective effects, areas to be tackled by both the private and the public health sectors. Finally, large investments will have to be made to improve tertiary care, to reorganise systems of care for acute patients and mainly to ensure prompt access and continuity of cardiac care and secondary prevention strategies for the whole population.

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Delay factors on the administration of thrombolytic therapy in patients diagnosed with acute myocardial infarction in a general hospital

Cited by 10 publications

References 9 publications

Independent Predictors of Late Presentation in Patients with ST-Segment Elevation Myocardial Infarction

Independent Predictors of Late Presentation in Patients with ST-Segment Elevation Myocardial Infarction

Perfil epidemiológico de pacientes com infarto agudo do miocárdio na microrregião de Itajubá (Minas Gerais)

Coronary artery disease in Brazil: contemporary management and future perspectives

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