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Master Thesis

Le Syndrome Coronaire Aigu avec élévation du segment ST en 2014 et 2015 dans le Libournais, analyse de la prise en charge depuis l’événement jusqu'à un an après la sortie de la cardiologie : étude observationnelle rétrospective au travers du Registre Aquitain de l'Infarctus du Myocarde (REANIM) et du Registre Aquitain de Cardiologie Interventionnelle (ACIRA)

Abstract : Cardiovascular diseases which are the leading cause of death throughout the world (WHO) give rise to public health concerns. We aimed to characterize the management of STEMI patients and their one-year outcome. 2014 and 2015 STEMI patients of the Libourne/Sainte Foy la Grande hospital emergency system were involved in a retrospective and observational study. The first endpoint was the management compliance with the 2017 recommendations from the ESC. The management analysis was based on both Aquitaine REANIM and ACIRA registers. Patients one-year outcome was analyzed through medical files. 149 patients were enrolled in this study with 77.2% of men. As regards the acute phase of STEMI, we observed rates of 42.3% for pre-hospital medical intervention and of 30% for ECG obtained within the first ten minutes. It should be pointed out a coronary angioplasty rate of 7% within the 60 minutes after the arrival at the Libourne emergency and of 40% within the 90 minutes after a pre-hospital intervention. When it is recommended, a thrombolysis rate of 13.3% is monitored. A reperfusion rate of 92.3% was obtained for less than 12-hour STEMI. Then, we monitored a rate of 94% for the prescription of the recommended treatment, a smoking prevention rate of 56% and a diet prevention rate of 78%. Inhospital mortality was 6% and one-year mortality was 8%. Several axes for improvement have been identified: amongst the population and family doctors with a “15” reflex from the start of the chest pain; amongst emergency doctors in order to improve the pre-hospital thrombolysis rate; amongst cardiologists to improve the secondary prevention of risk factors.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-02551042
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Submitted on : Wednesday, April 22, 2020 - 4:38:40 PM
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Anaïs Gagnepain. Le Syndrome Coronaire Aigu avec élévation du segment ST en 2014 et 2015 dans le Libournais, analyse de la prise en charge depuis l’événement jusqu'à un an après la sortie de la cardiologie : étude observationnelle rétrospective au travers du Registre Aquitain de l'Infarctus du Myocarde (REANIM) et du Registre Aquitain de Cardiologie Interventionnelle (ACIRA). Médecine humaine et pathologie. 2018. ⟨dumas-02551042⟩

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