ANALYSIS OF PRE-HOSPITAL TREATMENT OF ACUTE CORONARY SYNDROME
https://doi.org/10.20996/1819-6446-2007-3-5-4-8
Abstract
Aim. To evaluate the pre-hospital treatment of patients with acute coronary syndromes (acute myocardial infarction and unstable angina) in 2001 and 2006.
Material and methods. Retrospective pre-hospital treatment survey was performed in 1114 patients with acute coronary syndrome (acute myocardial infarction (AMI) or unstable angina (UA)) in 2001 and 2006.
Results. For acute myocardial infarction use of aspirin, β-blockers, heparin was 0%, 0%, 81,5% in 2001 and 23,9%, 8%, 13,4% in 2006, respectively. Use of aspirin, β-blockers, heparin in unstable angina were 0%, 16,2%, 12,3% in 2001 and 3,4%, 1,6%, 0,5% in 2006, respectively. Fibrinolytic therapy was not provided. Polypragmasia reduced in 2006 in comparison with 2001.
Conclusions. This survey demonstrates the discordance between existing current practice and guidelines for acute coronary syndrome.
About the Authors
O. V. Reshetko
Saratov Scientific Research Institute for Cardiology
Russian Federation
Russian Federation
R. M. Magdeev
Saratov Scientific Research Institute for Cardiology
Russian Federation
Russian Federation
N. V. Furman
Saratov Scientific Research Institute for Cardiology
Russian Federation
Russian Federation
References
1. Leal J., Luengo-Fernandez R., Gray A., et al. Economic burden of cardiovascular diseases in the enlarged European Union. Eur Heart J 2006;27:1610–9.
2. Голиков А.П. Достижения и перспективы научных исследований в области неотложной кардиологии. Клин мед 2002;(4):11-4.
3. Гогин Е.Е. Острый коронарный синдром: этапы диагностики, определяющие тактику оказания помощи. Тер арх 2001;(4): 5-11.
4. Daly C., Clemens F., Lopez-Sendon J. L. et al. The impact of guideline compliant medical therapy on clinical outcome in patients with stable angina: findings from the Euro Heart Survey of stable angina. Eur Heart J 2006;27:1298–304.
5. Mandelzweig L., Battler A., Boyko V. et al. The second Euro Heart Survey on acute coronary syndromes: characteristics, treatment, and outcome of patients with ACS in Europe and the Mediterranean Basin in 2004. Eur Heart J 2006;27:2285-93.
6. Всероссийское научное общество кардиологов. Рекомендации по лечению острого коронарного синдрома без стойкого подъема сегмента ST на ЭКГ. Редакция 2003. Кардиоваск тер профилакт 2004;4(приложение):1-42.
7. Чучалин А.Г., Вялков А.И., Белоусов Ю.Б., редакторы. Федеральное руководство по использованию лекарственных средств (формулярная система). М.: ГЭОТАР-Медиа; 2006.
8. Руководство по скорой медицинской помощи. М.: ГЭОТАР-Медиа; 2007.
9. Reed S.D., McMurray J.J.V., Velazquez E.J. et al. Geographic Variation in the Treatment of Acute Myocardial Infarction in the VALsartan In Acute myocardial iNfarcTion (VALIANT) Trial. Am Heart J 2006;152(3):500-8.
10. Явелов И.С., Грацианский Н.А. Российский регистр острых коро- нарных синдромов: лечение и исходы в стационаре при остром коронарном синдроме без подъемов сегмента ST. Кардиология 2003;(12):23-36.
11. Явелов И.С., Грацианский Н.А. Российский регистр острых коронарных синдромов: лечение и исходы в стационаре при остром коронарном синдроме с подъемами сегмента ST. Кардиология 2004;(4):4-13.
12. Fox K.A., Goodman S.G., Anderson F.A. et al. From guidelines to clinical practice: the impact of hospital and geographical characteristics on temporal trends in the management of acute coronary syndromes. The Global Registry of Acute Coronary Events (GRACE). Eur Heart J 2003;24:1414-24.
13. Метелица В.И. Справочник по клинической фармакологии сердечно-сосудистых лекарственных средств. М.: Бином; 2002.
14. Braunwald E, Antman EM, Beasley JW, et al. ACC/AHA 2002 guideline update for the management of patients with unstable angina and non–ST-segment elevation myocardial infarction-summary article: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on the Management of Patients With Unstable Angina). J Am Coll Cardiol 2002;40:1366 –74.
15. Antman E.M., Anbe D.T., Armstrong P.W., et al. ACC/AHA guidelines for the management of patients with ST-elevation myocardial infarction- executive summary: a report of the ACC/AHA Task Force on Practice Guidelines (Committee to Revise the 1999 Guidelines on the Management of Patients With Acute Myocardial Infarction. J Am Coll Cardiol 2004;44:671–719.
16. Bertand M.E., Simoons M.L., Fox K.A.A. et al. Management of acute coronary syndromes in patients presenting without persistent STsegment elevation. Eur Heart J 2000;21:1406–32.
17. Van de Wertf F., Ardissino D., Bertiu A. et al. Management of acute myocardial infarction in patients presenting with ST-segment elevation. Eur Heart J 2003;24:24-66.
18. Сулейменова Б.А., Ковалев Н.Н., Тоцкий А.Д. Эффективность нитроглицерина при остром коронарном синдроме на догоспитальном этапе. Кардиология 2003;(2):73-6.
19. Boersma E. and The Primary Coronary Angioplasty vs. Thrombolysis (PCAT)-2 Trialists’ Collaborative Group. Does time matter? A pooled analysis of randomized clinical trials comparing primary percutaneous coronary intervention and in-hospital fibrinolysis in acute myocardial infarction patients. Eur Heart J 2006;27:779–88.
20. Bjorklund E., Stenestrand U., Lindback J. et al. Pre-hospital thrombolysis delivered by paramedics is associated with reduced time delay and mortality in ambulance-transported real-life patients with ST-elevation myocardial infarction. Eur Heart J 2006;27:1146–52.
21. Никифоров Ю.В., Спирочкин Д.Ю. Обезболивание при остром коронарном синдроме. Росс кардиол журн 2004;(2):80-6.
Review
For citations:
Reshetko O.V., Magdeev R.M., Furman N.V. ANALYSIS OF PRE-HOSPITAL TREATMENT OF ACUTE CORONARY SYNDROME. Rational Pharmacotherapy in Cardiology. 2007;3(5):4-8. (In Russ.) https://doi.org/10.20996/1819-6446-2007-3-5-4-8
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