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U. Smur, . De-libourne, R. Registre, and A. Registre, Acute myocardial infarction with ST segment elevation in 2014 and 2015 in the Libourne territory, Retrospective observational study through the Aquitaine Registry of Myocardial Infarction (REANIM) and the Aquitaine Registry of Interventional Cardiology (ACIRA)

, Thèse d'exercice de Médecine Générale U.F.R des Sciences médicales, 146 rue Léo Saignat, p.33000

, Notre objectif était de caractériser la prise en charge des patients victimes d'un Syndrome coronarien aigu ST+ (STEMI) et leur devenir à un an de l'infarctus, une étude rétrospective observationnelle, les patients ayant présenté un STEMI en, 2014.

. Dans-le-réseau-urgences and . Smur-de-libourne, Sainte Foy la Grande ont été inclus. Le critère de jugement principal était la conformité de la prise en charge de la population selon les recommandations de l'ESC en

, Pour la phase aiguë du STEMI, nous observons des taux de 42,3% de médicalisation préhospitalière et de 30% d'ECG réalisés dans les 10 premières minutes. A noter, un taux de 7% d'angioplasties réalisées dans les 60 minutes à l'arrivée aux urgences de l'hôpital de Libourne, et de 40% pour une angioplastie réalisée dans les 90 premières minutes suite à la prise en charge en SMUR. Un taux de 13.3% de thrombolyse est observé lorsqu'elle est recommandée. Un taux de reperfusion de 92.3% était obtenu pour les STEMI de moins de 12h. Pour la suite de la prise en charge, nous observons un taux de 94% de prescription de traitement BASI, un taux de 56% de prévention du tabagisme et de 78% de prévention diététique. La mortalité hospitalière était de 6%, la mortalité à un an étant de 8%. Plusieurs axes d'amélioration ont été identifiés : auprès de la population et des médecins traitants avec un réflexe pour l'appel au 15 en cas de douleur thoracique, L'analyse de la prise en charge s'appuyait sur les registres aquitains REANIM et ACIRA. Le devenir à un an des patients était analysé par les dossiers médicaux 149 patients ont été inclus dans l'étude avec 77,2% d'hommes

, 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 oneyear 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, Cardiovascular diseases which are the leading cause of death throughout the world (WHO) give rise to public health concerns, 2014.