Behavior of acute myocardial infarction in intensive care cardiology wards during a one-year period

Abstract

Introduction: cardiac deaths are ranked first in developed countries and in Cuba too; the acute myocardial infarction is the one with greater morbidity. Objective: The present research aims to know the behavior of patients with acute myocardial infarction during admission. Method: a retrospective cross-sectional study with 246 patients admitted with the diagnosis of acute myocardial infarction was conducted at the Cardiology Intensive Care Unit of the Arnaldo Milian Castro Provincial University Hospital in 2010. The epidemiological characteristics, topographies, complications, treatment and mortality were described. Results: acute myocardial infarction was more common in males (169 patients versus 77 women) with a higher incidence after 46 years of age and in white patients (223). Overall mortality was 13%, in females it was 14.3% versus 12.4% males and increased progressively with age. A greater number of acute myocardial infarction was found with ST-segment elevation. The topographic location more commonly found was the inferior, with 72 patients, and the most lethal was the extensive anterior location (42.3%). The failure of Killip-Kimbal pumps II and III, atrioventricular block and ventricular fibrillation with 38, 23 and 22 patients respectively were the most common complications. Thrombolysis was performed in 48.3% of patients, anticoagulation in 96.7%, inhibitors of angiotensin-converting enzyme in 85%, aspirin in 81.3% and beta-blockers in 50% of paients. Conclusions: Acute myocardial infarction was more common in men, in white patients, and its incidence increased with age. The inferior location presented the highest incidence. Mortality was higher in women, in patients older than 75 years and in the most extensive infarctions. The most frequent complications were acute left ventricular dysfunction (Killip-Kimbal II and III), atrioventricular block and ventricular fibrillation. The most lethal ones were cardiogenic shock, cardiac rupture, and association with strokes. Thrombolysis had an acceptable use, a poor use of interventional therapy was linked to the use of beta-blockers, aspirin, anticoagulation and inhibitors of angiotensin converting enzyme.