Desfechos clínicos em pacientes com IAMCSST com apresentação atípica no estado de Sergipe-registro VICTIM

• Autor(a) principal: Menezes, Vitor Gois
• Data de Publicação: 2017
• Tipo de documento: Trabalho de conclusão de curso
• Idioma: por
• Título da fonte: Repositório Institucional da UFS
• Texto Completo: http://ri.ufs.br/jspui/handle/riufs/7459
• topic: Medicina; Saúde; Infarto do miocárdio; Reperfusão miocárdica em Sergipe; Mortalidade; Medicine; Myocardial infarction; Myocardial reperfusion in Sergipe; CIENCIAS DA SAUDE::MEDICINA

Introduction: Patients with STEMI can have a typical or atypical clinical presentation, and one in five patients with ACS will present an atypical clinical manifestation, with atypical angina or even without angina, and thus making the diagnosis more difficult and favoring delays, or even preventing treatment. Objective: Evaluate coronary reperfusion and mortality in patients with typical and atypical STEMI presentation in Sergipe state. Methods: Cross-sectional quantitative study, using data from the VICTIM registry (Via Crucis para Tratamento do Infarto do Miocárdio), from December 2014 to March 2017. Patients presenting with typical thoracic or epigastric pain, with or without other symptoms, were included in the typical group, patients with atypical thoracic pain or no pain, with or without other symptoms, were included in the atypical group. Results: 707 patients were analyzed, from which 615 (87%) presented typical manifestations and 92 (13%) presented atypical STEMI manifestations, with a mean group age of 61 (±11.8) and 64 (±14.3), respectively, p=0.033. Therapeutic procedures and clinical outcomes analysis showed us that, regarding primary PCI, patients with typical and atypical manifestations was conducted in 51.2% vs. 47.8%, respectively, p=0.514. Door-to-balloon time was longer in patients with atypical manifestations (152.2 vs. 119.5, in minutes, p=0.034). Regarding cardiovascular death in 30 days after MI, 11.9% of atypical patients and 7.9% of typical patients were affected, p=0.189. Conclusion: Older patients are more likely to present atypical STEMI manifestations. Patients with typical presentation have shorter door-to-balloon times, but both presentations exceeded the preconized ideal time. However there was no significant difference in mortality in 30 days after STEMI between typical and atypical manifestations.