The experience of hospital thrombolytic therapy of st-segment elevation myocardial infarction in regional vascular center
Author Affiliations1Railway Clinical Hospital on the Station of Chelyabinsk, Joint Stock Company «Russian Railways», 454048, Chelyabinsk, Dovator str., 23
2Railway Clinical Hospital on the Station of Chelyabinsk, Joint Stock Company «Russian Railways», 454048, Chelyabinsk, Dovator str., 23
Abstract
Objective. The analysis of some cases of hospital thrombolytic therapy in the regional vascular center. Material and methods. The capacity of reperfusion therapy in 2014, including hospital pharmacological therapy, is presented. Results. 436 (67.9 %) patients have had reperfusion therapy: percutaneous coronary interventions (PCI) in isolation – 326 (50.8 %), only thrombolytic therapy – 36 (5.6 %), pharmaco-invasive method – 74 (11.5 %). Thrombolytic therapy was performed in 110 (17.1 %) cases, 98 (15.2 %) from them - by ambulance teams. The need for hospital thrombolytic therapy occurred in 12 cases (1.9 %). In 9 cases, the main reason was impossibility to do primary PCI due to the occupancy of the room for angiography. In 8 cases thrombolytic therapy was performed by a recombinant protein containing the amino acid sequence of staphylokinase (Fortelyzin®), and it was effective. All patients have had successful PCI. Conclusions. In conditions of our regional vascular centre, we used thrombolytic therapy as a forced measure due to simple circumstances (the patient’s refusal of coronary interventions or allergic to contrast) or high occupancy of the angiographic operating room. The results of the administration of Russian thrombolytic agent Fortelyzin® have left a positive impression. Further accumulation of experience will determine the place of this medication in clinical practice.
Key words
References1. Bokerija L.A. Health Russia: Atlas. M., 2013. 420 p. [In Russian]
2. Bokerija L.A., Alekjan B.G. Endovascular diagnosis and treatment of diseases of the heart and blood vessels in the Russian Federation. M., 2013. 172 p. [In Russian]
3. State Program of the Russian Federation “Development of Health” approved Order of the Government of the Russian Federation of December 24, 2012, № 2511-p, Moscow. Russian newspaper. 2012, 31 dek. [In Russian]
4. Report on the State of Public Health and Health Organizations on the Results of the Executive Authorities of the Russian Federation for 2013. Available at: http://www.rosminzdrav.ru/ministry/61/22/stranitsa-979/doklad_2013. [In Russian]
5. Markov V.A., Vyshlov E.V., Karpov R.S. Coronary reperfusion in myocardial infarction with rise of segment ST: problems and solutions // Russian Journal of Cardiology. 2015. (1) 53-58. [In Russian]
6. National guidelines on the diagnosis and treatment of patients with acute myocardial infarction with ST-segment elevation ECG // Cardiovascular therapy and prevention. 2007. (8) 1-64. [In Russian]
7. The Task Force on Myocardial Revascularization of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS) // Russian Journal of Cardiology. 2015. (118) 5-81. [In Russian]
8. Sidel'nikov A.V., Chernysheva I.E., Koledinskij A.G. Comparative analysis of trombolytic`s effectiveness: the research continues // International Journal of Interventional Cardioangiology. 2014. (39) 44-50. [In Russian]
9. Chazov EI., Bojcov SA. Provision of medical care to patients with acute coronary syndrome within the framework of the establishment of regional and primary vascular centers in the Russian Federation // Vestnik of cardiology. 2008. (2) 5-11. [In Russian]
10. Keeley E.C., Boura J.A., Grines C.L. Primary angioplasty versus intravenous thrombolytic therapy for acute miocardial infarction a quantitative review of 23 randomized trials// Lancet. 2003. (361) 13-20.
About Authors (Correspondence):
Kireev K.A. – candidate of medical sciences, endovascular physician for diagnosis and treatment of department of endovascular diagnostic and treatment methods, e-mail: kkireev83@mail.ru
Krasnopeev A.V. – physician-resuscitator of department of anesthesiology and intensive care, e-mail: lead_guitar@mai.ru
Full Text
