Abstract

Registries are an interesting tool for continually evaluation of clinical practice regarding acute coronary syndrome (ACS) which is considered as a public health problem.

Objective

Analyzing the preliminary results of our local registry of ACS (ReSCUS registry) in order to verify our adherence to the guidelines and propose a strategy to improve patient outcomes.

Methods

Only data of patients with STEMI were selected for this study during the period from 1 February 2014 to 17 May 2016. 

We analyzed patients’ demographic and clinical characteristics, electrical characteristics, the time of first medical contact, the delays of medical care, the delays to the balloon or thrombolysis and the overall time of reperfusion. We noted for all the patients the major cardiovascular adverse event (MACE) registered at In-hospital stay, after 1month, 6months and 1 year later. 

For the univariate analysis, we attempted to determine the prognostic factors associated with hospital mortality of ACS.

Results

We included 150 patients. The average age was 61 ± 12 years with a sex ratio of 6.14. Smoking is the most common risk factor (53%). STEMI occurs anterior territory on EKG in 40% and inferior territory in 26% of cases. Only 17% of patients received medical transport to our emergency department. Complications of STEMI were detected in 47, 3% of patients. The median delay to the first EKG was Of 21 minutes. Angioplasty was the reference method of revascularization in our study. 

At the hospital phase, the overall mortality was 8%. The age more than 65 years, diabetes, the occurrence of a cadiogenic shock were the factors most correlated with the mortality in the hospital phase. The 12-month overall MACE rate was noted in 9.6% of cases.

Conclusion

Results of our study seem encouraging but more efforts are necessary to improve reperfusion delays and overall outcomes. 

Keywords: STEMI_registry_emergency management_ time delays_reperfusion_predictive factors