[Patient care of patients with myocardial infarction in Hungary. Analysis of National Myocardial Infarction Registry data collecting in 2015]. / A szívinfarktus miatt kezelt betegek ellátása Magyarországon. A Nemzeti Szívinfarktus Regiszter 2015. évi adatainak elemzése.

The authors summarize the most relevant data of myocardial infarction patients according to the National Myocardial Infarction Registry data base. In 2015 12,681 patients had 12,941 acute myocardial infarctions. Less than half of patients (44.4%) were treated with ST elevation myocardial infarction. National Ambulance Service was the first medical contact of more than half (51.4%) of patients with ST elevation infarction. Prehospital thrombolysis was occasionally done (0.23%), but 91.6% of the patients were treated in hospital with invasive facilities. The median of the ischaemic time (time between onset of symptoms and arrival at the invasive laboratory) was 223 minutes. Most of the patients (94%) with positive coronary arteriography were treated with percutaneous coronary intervention. The 30 day mortality of the whole group was 12.8% vs. 8.6% of patients treated with an invasive procedure. CONCLUSION: comparing the national and international registry data we conclude that we should analyse and decrease the prehospital delay time to improve the patient care in Hungary. Orv. Hetil., 2017, 158(3), 90-93.

[Data of the morbidity and mortality index of the acute coronary syndrome in the South Trans-Danubian Region between 1999 and 2002]. / Az akut coronaria szindróma morbiditási és mortalitási adatai a dél-dunántúli régióban 1999 és 2002 között.

Data of the morbidity and mortality index of the acute coronary heart disease in the South Trans-Danubian Region between 1999 and 2002. South Trans-Danubian Regional Acute Coronary Registry. Based on GYOGYINFOK database, the authors' purpose was to monitor the morbidity and mortality of acute coronary heart diseases (acute coronary syndrome, acute myocardial infarction) in the approximately one million people inhabiting the South Trans Danubian Region. Data were obtained using the financing data sheets reported to GYOGYINFOK by 15 in-patient health care institutions located in the region. The regional data were compared nation-wide ones as well. The observed diagnoses correspond to diseases the codes of which range from I 20.00 to I 22.90, according to BNO classification. The data of years 1999, 2000, 2001 and 2002 have already been processed and categorized by gender and age-groups. Hospital mortality, therapeutical procedures (thrombolysis, GP IIb/IIIa receptor blocker) as well as the parameters of progressive care have all been evaluated. Of the processed 4 years, the data of 8431 patients are already recorded in the registry. The rate of the thrombolytic therapy reached patients was decreased from 26.01% (which was detailed in 1999) to 7.39% into 2002 in our region, but the rate was nearly constant 16.1% in 1999 and 13.28% in 2002 in the country. The rate of the GP IIb/IIIa therapy reached patients was increased from 2.15% to 6.66% in our region, while it was increased from 0.66% to 3.96% between 2000 and 2002 in the country. Mortality in the hospitals decreased in the case of male from 14.44% to 8.7% in the region, and from 20.28% to 16.18% in the female. At the same time the hospital mortality was constant in the country, in males it was 14.39% in 1999, and 13.11% in 2002, and in females it was 20.00% in 1999, and 18.81 in 2002. As regards the therapeutical procedures--based on the data processed up to the present--it can be observed that classic thrombolytic therapy becomes de-emphasized while treatments with GP IIb/IIIa receptor blockers as well as the intervention coupled to these gain ground. The authors consider the creation of this registry a very important beginning step in building the cardiological map of the region.

[Facilitated revascularisation in myocardial infarction with ST-segment elevation]. / Facilitált revascularisatiós stratégia ST-elevációs myocardiuminfarctusban.

AIMS: The authors performed urgent coronarography and revascularisation after administering a combined half dose of alteplase (tissue plazminogen activator) and eptifibatide (glycoprotein II/bIIIa receptor blocking agent) to patients suffering from acute coronary syndromes with persistent ST-segment elevation. METHODS: During the period between 01 April to 15 December, 2001. 20 patients (16 men and 4 women, mean age: 55.6 years) were treated. The localization of infarction on the basis of ST-segment elevation was: 9 cases inferior, 10 cases anterior and patient with left bundle branch block in 1 cases. The mean time between the infarct related angina and hospital admission was 158 (30-600) minutes. The combined medical therapy was initiated after 34 (15-150) minutes on the average admission, and 123 (71-210) minutes later the patients were in the catheter laboratory. RESULTS: Coronarography showed TIMI-0 flow in 4 cases, TIMI-2 flow in 3 cases and TIMI-3 flow in 13 cases. Acute percutan coronary intervention was done in 14 cases, aorto-coronary bypass surgery was performed in 4 cases (2 of them were emergency operations, the other 2 were done electively). Besides postpunctional haematomas, hemorrhagic complications in the form of haematemesis were observed in 2 cases, but there was no need for transfusion. The mean CK-MB release (between 14 patients) was 230.4 (30-1176) U/l. One patient died after the emergency bypass surgery. CONCLUSIONS: On the basis of initial results the authors emphasize the importance of working out the optimal revascularisation strategy for acute coronary syndrome patients with ST-segment elevation in every Hungarian catheter centre. The authors find this method--in their case the catheter laboratory is 60 kms away, time of transport is approximately 70-90 minutes--an effective and safe alternative therapy in patients under the age of 75 years with acute myocardial infarction.