The change in hospital care of patients suffering from acute myocardial infarction with ST elevation during the last decades in the county hospital, Gyula – from „armchair” to the hemodynamic laboratory
█ Original article
Katona András, Márk László, Nagy Erzsébet, Dani Győző, Sziklai György, Vendrey Róbert, Baranyai Csaba, Jambrik Zoltán
Békés Megyei Központi Kórház, Pándy Kálmán Tagkórháza, Kardiológia Osztály és Invazív Kardiológiai Részleg, Gyula
Summary: The authors analysed the data of 5640 patients with ST segment elevation in the acute phase of chest pain, treated on their department between 1970 and 2015. Management of patients with myocardial infarction changed in accordance with the international guidelines. Accordingly a reduction can be clearly seen in hospital mortality from 40% („armchair period”) to 20% due to the circumstances of Coronary Care Unit. Later the introduction and consistent administration of systemic thrombolytic therapy cut in half the hospital mortality again. The treatment in their Haemodynamic Laboratory, foremost in Hungary from the beginning with 7/24 acute infarction management started on 1st of July 2013. From that time 96.7% of patients with ST elevation myocardial infarction underwent to an invasive procedure. Hospital mortality was reduced fewer than 6%. As most of patients have high cardiovascular risk, the authors emphasize that recommendation of secondary prevention treatments at discharge can be used as a quality assurance marker and their administration has beneficial effects on prognosis. The knowledge of the population about the signs of acute coronary syndrome should also be improved as it could necessarily result in a shorter prehospital time interval as well.