ISSN 2415-3060 (print), ISSN 2522-4972 (online)
  • 27 of 57
JMBS 2020, 5(1): 187–191
Clinical Medicine

The State of Medical Assistance for Acute Coronary Syndrome in the Inhabitants of the Transcarpathian Mountain Regions

Rishko M. V., Dancha N. Y., Chendey T. V., Ratochka Ya. H.

The purpose of the study was to study the effectiveness of providing medical care to patients with acute coronary syndrome in the Transcarpathian region, depending on the region of residence. Material and methods. Survey results of 756 patients in Transcarpathian mountain and plain regions with a diagnosis of acute coronary syndrome documented in primary medical records. The date and time of the first medical contact and diagnosis, reperfusion treatment, and convalescent status at the time of the event were considered. All patients according to clinical diagnosis at admission were divided into four groups: 1) patients with acute coronary syndrome with ST segment elevation on ECG (STEMI); 2) GIM patients with Q tooth (Q-IM); 3) patients with acute coronary syndrome without ST segment elevation on ECG (NSTEMI); 4) patients with GIM without Q tooth (non-Q-MI). Patients were divided into 3 groups, depending on the transportation distance to the Transcarpathian Regional Clinical Cardiac Dispensary. The first group consisted of patients whose transport distance was up to 50 km, the second group was with 50-100 km distance and the third group had more than 100 km distance. Results and discussion. The number of acute coronary syndrome cases in group I was 206 (59.2%), in group II it was 96 (70%), in group III it was 94 (34.7%). Primary coronary intervention was performed in 193 (55.4%) patients in group I, 71 (51.8%) in group II patients, and 90 (33.2%) in group III patients. Thrombolytic therapy was performed in 3 (0.9%) patients in group I, 1 (0.73%) in group II patients and 6 (2.21%) in group III patients. The median transport distance to the reperfusion center in group I was 5 km (interquartile range: 5-35), group II-83 (interquartile range 69.7-98) km, group III-128 (interquartile range 111-164) km, p> 0.05. The median time from the first medical contact to diagnosis was 30 min for group I, 17 min 30 s for group II, 30 min for group III, p >0.05. Mortality among patients in group 1 was 0.86%, among patients in group II it was 13.13%, among patients in group III it was 13.65%, p<0.0001. Conclusion. In primary coronary intervention, mortality of patients with acute coronary syndrome depended on the region of residence. The farther the distance from the catheterization center, the less patients undergo urgent primary coronary intervention, which is associated with delayed diagnosis of acute coronary syndrome and, accordingly, untimely transportation of the population to the catheterization laboratory. Hospital mortality is significantly reduced in patients undergoing urgent primary coronary intervention.

Keywords: acute coronary syndrome, primary coronary intervention

Full text: PDF (Ukr) 515K

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