Authors

• Irzal Hadžibegović — General Hospital “Dr. Josip Benčević”, Slavonski Brod, Croatia — ORCID: 0000-0002-3768-9134
• Đeiti Prvulović — General Hospital “Dr. Josip Benčević”, Slavonski Brod, Croatia — ORCID: 0000-0002-8041-1197
• Krešimir Gabaldo — General Hospital “Dr. Josip Benčević”, Slavonski Brod, Croatia — ORCID: 0000-0002-0116-5929
• Marijana Knežević Praveček — General Hospital “Dr. Josip Benčević”, Slavonski Brod, Croatia — ORCID: 0000-0002-8727-7357
• Katica Cvitkušić Lukenda — General Hospital “Dr. Josip Benčević”, Slavonski Brod, Croatia — ORCID: 0000-0001-6188-0708
• Ivica Dunđer — General Hospital “Dr. Josip Benčević”, Slavonski Brod, Croatia — ORCID: 0000-0002-3340-7590
• Martina Menegoni — General Hospital “Dr. Josip Benčević”, Slavonski Brod, Croatia — ORCID: 0000-0002-4295-9039
• Domagoj Mišković — General Hospital “Dr. Josip Benčević”, Slavonski Brod, Croatia — ORCID: 0000-0003-4600-0498
• Božo Vujeva — General Hospital “Dr. Josip Benčević”, Slavonski Brod, Croatia — ORCID: 0000-0003-0490-3832

Keywords

acute coronary syndrome, percutaneous coronary intervention, protocol

DOI

Full Text

**Introduction**: National networks of treatment of acute myocardial infarction with ST elevation (STEMI) are a key segment in the standardization of the quality of care of patients with acute coronary syndrome (ACS), with strictly defined protocols, which should be tailored to each region depending on the organizational capabilities. (1) Patients with acute coronary syndromes without ST segment elevation (NSTE-ACS) are not usually treated as part of the network, and require additional efforts in treatment standardization. **Patients and Methods**: We analyzed data on patients with percutaneous coronary intervention (PCI) performed in ACS in the catheterization laboratory in Slavonski Brod in the period between 2014 and 2015, and compared it with data obtained from the beginning of 2016 after the adoption of standardized Protocols for the entire region of Western Slavonija (2). **Results**: In the period after the adoption of the protocol, the number of primary PCIs in STEMI increased by 36%. Proportion of transported patients undergoing primary PCI in STEMI also increased, and amounted to 48% by September 2016. First medical contact in 36% of patients with STEMI occurred by means of patient’s own transportation. All transported patients passed through the Emergency Department of hospitals without PCI capabilities. By the end of September 2016, 96% of patients with STEMI were pretreated with aspirin, ticagrelor and unfractionated heparin. The share of primary PCI in cardiogenic shock increased from 2.5% to 7.8%. Total in-hospital mortality after primary PCI in STEMI increased insignificantly from 5.2% to 6.9% in 2016. Number of PCI in NSTE-ACS increased by 14%. PCI in NSTE-ACS was organized within 72 hours in 81% of cases. Proportion of PCI in transported patients with NSTE-ACS within 24 hours increased by 13%. Total in-hospital mortality after PCI in NSTE-ACS was very low and did not change notably. **Conclusion**: The data collected using the standardized ACS treatment protocol helped in maintaining the quality of treatment and identifying new problems which require new solutions. Standardized protocols for treatment of all patients with ACS should be a part of the strategy for formation of regional and national networks for emergency PCI implementation within the whole spectrum of ACS.

Literature

1. Putera M, Roark R, Lopes RD, Udayakumar K, Peterson ED, Califf RM, et al. Translation of acute coronary syndrome therapies: from evidence to routine clinical practice. Am Heart J. 2015;169(2):266–73. https://doi.org/10.1016/j.ahj.2014.09.015
2. Prvulović Đ. Developing a Treatment Quality Monitoring Program for Patients with Acute Coronary Syndrome in Western Slavonia. Cardiol Croat. 2015;10(11-12):263–8. https://doi.org/10.15836/ccar2015.263