[Acute myocardial infarction management in a hospital center with emergency ambulance service and intensive care unit, without cardiac catheterization laboratory].

Annales de cardiologie et d'angeiologie

PubMedID: 12471795

Bordier P, Comiant I, Robert F, Touchard P, Chourbagi M. [Acute myocardial infarction management in a hospital center with emergency ambulance service and intensive care unit, without cardiac catheterization laboratory]. Ann Cardiol Angeiol (Paris). 2002;51(4):181-7.
OBJECTIVES
We report our experience about acute myocardial infarction management in a small hospital with no possibility of coronarography.

MATERIALS AND METHODS
In 1998, 60 patients were hospitalized for acute myocardial infarction < 10 days. We studied characteristics of patients, the management of myocardial infarction, the mortality.

RESULTS
Our population consisted of 83% of men and 17% of women with a mean age of 63.5 and 74 years respectively. An out-hospital doctor was first warned by 60% of patients. For hospitalization, the emergency ambulance service (SMUR) was used in 45% of cases, out-hospital doctors using these means of transport in 36% of cases. The global time of intervention was 18h30. The mean time for patients managed in the first sixth hours was 2h10. A thrombolysis was applied for 35% of patients (15% in prehospital that is to say 32% of "SMUR patients", and 20% in hospital). A transfer to the neighbouring university hospital for primary or rescue coronary angioplasty was decide for 41% of patients. A total of 77% of our patients underwent a coronarography. The global mortality at 10 days was 13.3% (< 75 years: 10.6%; > 75 years: 23%).

CONCLUSIONS
A low volume centre and with no possibility of coronarography can manage the acute phase of myocardial infarction with results closed to those of the literature.