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[Life Threatening Complications in Patients With ST-Elevation Acute Coronary Syndrome-Dependence on Reperfusion Interventions (Data of Federal Register of Patients With Acute Coronary Syndrome)].

AIM
to study rate and type of life-threatening complications (LC) in patients with ST-Elevation (STE) Acute Coronary Syndrome (ACS) and their relation to implementation of reperfusion measures.


MATERIAL AND METHODS
Database of the Federal Register of patients with ACS (FRACS) which functioned from 01/01/2009 to 01/01/2014 contains information on 212304 patients with verified diagnosis of ACS. From this pool using random number generator we selected a cohort comprising 10348 patients with STEACS (60% men, mean age 63.5+/-0.1 clinical systolic and diastolic arterial pressure [AP] 135.2+/-0.3 and 81.9+/-0.2 mm Hg, respectively). Killip class was used for determination of degree of acute heart failure.


RESULTS
Most frequent forms of LC were heart rhythm disturbances (6.2%) and cardiogenic shock (5.4%). Patients subjected to percutaneous coronary intervention (PCI) including those in whom pharmacoinvasive approach was used had less LC and lower hospital mortality than patients who received only thrombolytic therapy (TLT). Reperfusion measures were administered mostly to patients with class I-II acute heart failure. Hospital mortality was highest (9.47%) among patients not subjected to reperfusion measures and lowest (1.09%) among patients treated with PCI+TLT.


CONCLUSION
FRACS assesses LC in patients with STEACS in the context of implemented reperfusion measures. Data of FRACS can be used by the health service authorities for improvement of medical aid to patients with STEACS.