Initial treatment, demographic characteristic and follow-up of patients with STEMI in emergency medical services Pančevo

Abstract

Introduction: Acute coronary syndrome (ACS) is the most urgent medical condition. ST-elevation myocardial infarction (STEMI) is the most severe form, with complete interruption of blood flow to part of the myocardium. The main goal of treatment is reperfusion. Prehospital treatment, according to recommendations, includes dual antiplatelet therapy (DAPT) -aspirin and a P2Y12 inhibitor -clopidogrel or ticagrelor, with recent studies favoring ticagrelor. The aims of the study were to determine the frequency, demographic characteristics and initial treatment of ACS occurrence with a separate STEMI patients, as well as the frequency of DAPT administration in STEMI. We also monitored whether pre-hospital STEMI patients were referred for coronary angiography. Material and methodology: The retrospective research covered the period from 01.01.2022. until 30.06.2022. Patients with ACS, especially STEMI, were gathered from the protocols in order to determine the frequency of DAPT administration. Through the transport protocol (TR), we monitored which of the prehospital STEMI patients were referred for coronary angiography. The results are presented through descriptive statistics. The Independent Samples Test (p<0.05) was used to analyze the significance of the difference, and the data was processed in the SPSS 15.0 program. Results: Out of 10953 patients, 315 (2.87%) had ACS, and 34 (10.8%) of them had STEMI. There were more men with STEMI 26 (76.47%) than women (23.53%). The average age of men with STEMI was 63±10.58; and the woman 61.37±10.01 years. There is no statistically significant difference between the sexes (p=0.09). All 34 (100%) prehospital STEMI patients were given DAPT-aspirin and ticagrelor. All these patients were also referred for coronary angiography. Discussion: In our research, there were more men than women. In all STEMI patients, 34 (100%) were administered DAPT, while in the EUROMAX study, the use of P2Y12 inhibitors was 95.7%. All of ours prehospital STEMI pacients were then transported for coronary angiography. Conclusion: In the observed period, DAPT was used in all STEMI patients in prehospital conditions. Emergency medical service is an important link in the initial care of STEMI patients and their transport.