ABSTRACT
AimThe aim was to study retrospectively the possible changes in practice patterns in the managementof patients with acute myocardial infarction who were admitted to the State Second Central Hospitalduring the last 5 years.Material and MethodThis study conducted at the State Second Central Hospital in September 2014.Patients with acute myocardial infarction were divided into 2 groups: main and control. Main groupincluded 95 patients with myocardial infarction who were treated from 2010 to July 2014. Controlgroup included 102 patients with myocardial infarction who were treated from 2005 to 2009.From 2005 to 2012 patients fulfilled the diagnostic criteria of myocardial infarction based on WHOcriteria. From 2013 to 2014 patients fulfilled the diagnostic criteria of myocardial infarction based onnational guideline’s criteria. Differences in proportions in the groups were tested with the chi squaretest. P value of <0.05 was considered significant.ResultsA total 197 patients (mean age 71.2±6.1, 62% man, and 38% women) with acute myocardial infarctionwere enrolled. More than half had a history of arterial hypertension. Atypical forms of myocardialinfarction increased from 25.8% in 2005-2009 to 40.4% in 2010-2014. ST elevation myocardialinfarction and non ST elevation myocardial infarction were detected in 61% and 39% of patientstreated in 2010-2014. Diagnostic use of troponin was increased significantly in last 5 year (44.2% vs.88.6%, p<0.05).The study revealed only 17.2% of patients with acute myocardial infarction met the national guidelinesgoal of pre-hospital time <12 hours. Eighty four (88.3%) patients of the main group received medicaltherapy and 11(11.7%) treated with percutaneous coronary intervention. Aspirin was prescribed in80.7% of main group, heparin in 97.9%, ACE inhibitors in 47.9%, Beta blocker in 14.9% within 24hours of acute myocardial infarction.ConclusionsCompared with control group use of troponin and invasive treatment strategy has increased since2010 in the management of patients with acute myocardial infarction. Delay of pre-hospital timeremains an actual problem in the management of acute myocardial infarction.