Author: Cristina M. Calcan

Evolution of mortality rates in ST elevation myocardial infarction

The purpose of this paper is to provide information about mortality rate in patients undergoing primary angioplasty for STEMI. Cardiovascular diseases lead to one third of the deaths worldwide, surpassing the mortality rate produced by neoplasia, acute respiratory failure and diabetes mellitus all together. In the world, approximately 17 million die annually because of cardiovascular disease and every 5 seconds one is suffering from a myocardial infarction. In 2010, in our country was implemented a national program (RO-STEMI) to offer rapid interventional treatment for patients with STEMI, aligned to ESC Guidelines. At the beginning only small parts of the patients were transferred to the hospital in charge for STEMI, so, we chose to study patients from the second year of the program and from last year. We made a retrospective study, including patients with STEMI that reached our hospital for primary angioplasty in the first 12h after the debut of the symptoms, aiming to make a parallel between the in-hospital mortality rates at maximum one month after the primary PCI. In order to be included, the patients must present ST elevation and another 1 out of 3 criteria (clinical, echocardiographic and biological changes suggestive for myocardial infarction). The main target was to evaluate the evolution of early mortality rates post primary PCI after the changes in the ESC Guidelines and the progresses in the medical field. A secondary target was to correlate mortality rates with the presence of comorbidities or risk factors. INTRODUCTION Alexander Muirhead is reported to have attached wires to a feverish patient's wrist to obtain a record of the patient's heartbeat in 1872 at St Bartholomew's Hospital.[1] Another early pioneer was Augustus Waller, of St Mary's Hospital in London.[2] His electrocardiograph machine consisted of a Lippmann capillary electro- meter fixed to a projector. The trace from the heartbeat was projected onto a photographic plate that was itself fixed to a toy train. This allowed a heartbeat to be recorded in real time. in Leiden, working the Netherlands, used the string galvanometer first practical electrocardiograph) he invented in 1901.[2] (the than both This device was much more sensitive the capillary electrometer Waller used and the string Galvano- meter that had been invented in 1897 by the separately engineer Clément French Ader.[3] An initial breakthrough came when Willem Einthoven, Einthoven had previously, in 1 Carol Davila University Central Emergency Military Hospital, Bucharest 2 Titu Maiorescu University, Faculty of Medicine, Bucharest 7