Cardiology Letters 2013, 22(2):115-124

Current trends in management of STEMI in the Slovak Republic. The analysis of the SLOVAKS-2 registry from 2011.

Studenčan M¹, Kovář F², Hricák V³, Kurray P⁴, Gonçalvesová E³, Kamenský G⁵

¹ Kardiocentrum FNsP J. A. Reimana v Prešove

² I. interná klinika Univerzitnej nemocnice v Martine

³ Národný ústav srdcových a cievnych chorôb a.s. v Bratislave

⁴ Kardiocentrum Nitra, s.r.o. v Nitre

⁵ V. interná klinika Univerzitnej nemocnice v Bratislave, Slovenská republika

Objective: Analysis of the management of STEMI patients in the Slovakia in 2011. The aim of the analysis is bring attention to inadequacies, and to support implementation of the latest medical knowledge into the clinical practice.

Methods and results: Data collection was conducted in August and September 2011. We have evaluated data from 69 treatment sites in Slovakia. These sites represents 85% of all workplaces treating ACS patients in the country. In this analysis we have evaluated of 1580 cases of ACS (STEMI, UAP and NSTEMI). STEMI cases represent 30.6% of all ACS. The average age of patients with STEMI was 63.8 (± 12.8). Representation of women was 30%. 80.6% of STEMI patients were admitted to PCI-centres. This was as primary hospitalization or secondary transfer. The proportion of STEMI admitted via EMS reached 88.7%. Primary reperfusion treatment was accomplished in 76.0% of patients (64.7% primary PCI, 11.3% fibrinolysis). 82.3% STEMI patients were admitted within 12 hours of symptom onset. The median of total ischemic time was 219 minutes. Our analysis confirms a very good standard of pharmacological treatment (98.3% aspirin, 92.6% clopidogrel, 93.5% statins, 85.3% ACE/AT1, 87.6 beta-blockers). In-hospital and 6-month STEMI mortality was 5.99% and 13.79%. The most common cause of death was cardiogenic shock (69.0% of all deaths).

Conclusion: In the year 2011 we saw a positive trend in increasing the proportion of patients treated with primary PCI. Hospital mortality decreased and total ischemic time shortened significantly. A persistent problem is the remarkable time delay incurred by patients themselves and the inadequate ability of EMS personnel to perform ECG diagnostic of STEMI on site. Introducing of primary reperfusion treatment within aceptable time interval and optimalization of antithrombotic regimen remain the main challenges for medical personnel in the nearest future.

Keywords: acute coronary syndrome; STEMI; primary PCI; reperfusion treatment; transport; time intervals; mortality; registry; SLOVAKS

Published: February 1, 2013  Show citation