DEFECTS OF PROVIDING MEDICAL CARE TO PATIENTS WITH ST SEGMENT ELEVATION ACUTE CORONARY SYNDROME WHO DID NOT RECEIVE REPERFUSION THERAPY

Aim. Assess defects in the provision of medical care to patients with ST segment elevation acute coronary syndrome, who did not receive reperfusion therapy. Materials and Methods. The study included patients with acute coronary syndrome with ST segment elevation who did not receive reperfusion therapy being hospitalized to the primary vascular units. The analysis of medical records of hospitalized patients was carried out. Results. The study included 113 patients who satisfied the inclusion criteria, of which 56.6% were men. The average age was 70.3±2.8 years. The most common complaints of patients were chest pain, shortness of breath, weakness, nausea and cold sweat. Most patients had comorbid pathology: arterial hypertension, chronic heart failure, and stable angina pectoris. The reperfusion card was filled out by medical personnel in 47.8% of cases. In 26.5%, the reason for rejection of reperfusion therapy was not clear from the medical records. A loading dose of antiplatelet drugs was used in 76.1% of cases. Anticoagulant parenteral therapy was carried out in 90.2% of cases. During stay in hospital, markers of myocardial damage were determined only in 75.2% of patients. Noteworthy is the low frequency of implementation of echocardiography in the first 24 hours – 12.4%. Despite the high frequency of administrations of the main groups of medical drugs during hospitalization, on discharge from hospital the number of administrations decreased. On discharge, coronary angiography was recommended to only 20.4% of patients. Conclusion. In patients with acute coronary syndrome with ST segment elevation, who did not undergo reperfusion therapy, defects in the provision of medical care were found that could affect the prognosis. The data obtained require further study and should be taken into account in development of educational programs for cardiologists, emergency medical specialists, and anesthesiologists-resuscitationists.