ĐẶC ĐIỂM LÂM SÀNG, CẬN LÂM SÀNG Ở BỆNH NHÂN NHỒI MÁU CƠ TIM CẤP CÓ ST CHÊNH LÊN NHẬP VIỆN MUỘN

Abstract

Objective: To study clinical, paraclinical, and electrocardiographic characteristics in patients with late ST-elevation acute myocardial infarction.  Methods: Descriptive, cross-sectional study in patients with ST-elevation acute myocardial infarction with a confirmed diagnosis and percutaneous coronary angiography at the Department of Cardiovascular Intervention, Cardiovascular Center - Military Hospital 103 and Vietnam Heart Institute - Bach Mai Hospital from October 2019 to July 2020. Results: Through the study of 91 patients with ST-elevation acute MI, 47 patients arrived at the hospital 12 hours before, 29 patients arrived late from 12-48 hours, and 15 patients arrived very late after 48 hours from the time of onset. Symptom onset: Compared with patients with ST-elevation acute MI who came to the hospital early, the acute MI group who arrived late and very late had no differences in age, gender, occupation, educational level, cardiovascular risk factors, pulse parameters, and blood pressure upon admission. The proportion of patients in the late-arriving group transported by ambulance was lower than that in the early-arriving group (37.9%, 95.7%, p<0.05). Atypical angina was more common (20.7%; 2.1% p<0.05); Troponins and NT-proBNP concentrations were higher (p<0.05); The rate of third-degree atrioventricular block was higher (13.3%;10.3%;2.2%), the rate of atrial fibrillation in the very late group was high (13.3%); Late and very late patients with indications for coronary artery intervention have a high rate of stable discharge from the hospital (96.6%; 93.3%). Conclusion: Age, gender, cardiovascular risk factors, pulse, and blood pressure before admission were not statistically significant. There were statistically significant differences in transport mode, atypical angina, and higher Troponins and NT-proBNP concentrations.