Bráð kransæðastífla á Íslandi 1982-1983 : horfur og áhrifaþættir fyrir daga seglaleysandi meðferðar

• Main Authors: Uggi Agnarsson, Nikulás Sigfússon, Inga Ingibjörg Guðmundsdóttir, Ingibjörg Stefánsdóttir
• Format: Article in Journal/Newspaper
• Language: Icelandic
• Published: Læknafélag Íslands, Læknafélag Reykjavíkur 2009
• Subjects: Kransæðasjúkdómar; Hjarta- og æðasjúkdómar; Myocardial Infarction; Coronary Vessels; Iceland; Survival Analysis; Coronary Angiography; Hjarta; Smella
• Online Access: http://hdl.handle.net/2336/65774

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn View/Open This nationwide study describes the short- and longterm outcome of acute myocardial infarction in Iceland 1982-83 prior to the routine use of aspirin and thrombolytic therapy. The material consists of 486 cases of acute myocardial infarction, 390 men and 96 women aged 25-64 years. Death prior to hospitalization occured in 124 cases but hospital treatment was given to 287 men and 75 women. Evidence of a previous myocardial infarction was found in 22%. An anterior myocardial infarction was present in 29% and an inferior myocardial infarction was present in 31%. The 28 day mortality was 12.4% but the long-term mortality over a mean of 7.1 year was 35.9%. The principal determinants of the risk of death in both sexes were ST-segmentelevation on admission ECG with a relative risk of 1.78, the use of digitalis and diuretics prior to the onset of an acute myocardial infarction with a relative risk of 1.89 and 1.72. Those treated with inotrophics in hospital had a relative risk of 2.81 but patients treated with anticoagulants in hospital had an improved prognosis with a relative risk of 0.45 but nitrates and b-blockers did not affect the outcome. Rannsókn þessi nær til allra skráðra tilfella af kransæðastíflu á Íslandi fyrir árin 1982-1983. Á þeim tíma var meðferð með segaleysandi lyfjum og acetýlsalícýlsýru ekki hafin hér á landi. Alls voru skráðir 486 sjúklingar með bráða kransæðastíflu, 390 karlar og 96 konur á aldrinum 25-64 ára. Þá létust 124 sjúklingar áður en tókst að flytja þá á sjúkrahús en 287 karlar og 75 konur voru lagðar inn á sjúkrahús. Vísbendingar um fyrri kransæðastíflu voru taldar vera fyrir hendi í 22% tilfella. Áverki á framvegg hjartans var talinn vera til staðar hjá 29% sjúklinga, en áverki á undirvegg hjá 31% sjúklinga. Dánartíðni inniliggjandi sjúklinga var 12,4% innan 28 daga frá byrjun einkenna en dánartíðni yfir lengra tímabil (að meðaltali 7,1 ár) var 35,9%. Helstu áhrifaþættir á horfur voru ...