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Revista Uruguaya de Cardiología

versión impresa ISSN 0797-0048versión On-line ISSN 1688-0420

Resumen

MOREIRA, Eduardo et al. Acute myocardial infarction away from the centers of hemodynamics, perception of quality of life post treatment with fibrinolytics and related factors. Rev.Urug.Cardiol. [online]. 2019, vol.34, n.1, pp.108-130. ISSN 0797-0048.  http://dx.doi.org/10.29277/cardio.34.1.9.

Introduction:

mortality in acute myocardial infarction with ST-segment elevation has decreased, despite this, there is evidence suggesting a long-term deterioration of quality of life in these patients.

Objective:

to evaluate the perceived quality of life and related factors in patients who had an ST-segment elevation myocardial infarction and received reperfusion treatment with fibrinolytics.

Material and methods:

application of EQ-5D-5L questionnaire to assess quality of life in patients with ST-segment elevation myocardial infarction selected among those admitted in the period from June 2007 to June 2017 in a private intensive care unit outside the country’s capital.

Results:

86 patients were analyzed with a median age of 67.5 years (interquartile range = 59-77.5). 77% received fibrinolytics of which 74% presented reperfusion criteria. The treatment was initiated before 120 minutes in 74% of the cases. Among the survivors at the start of the study, 30 patients were selected at random for evaluation of the quality of life. The mean follow-up was 6 years (4-8) from the event. The altered aspects in quality of life were: mobility 6/23( 26%), self-care 4/23 (17%), usual activities 6/23( 26%), pain 4/23(17%) and an altered global quality of life 8/30( 27%). On a scale of 0-100, the perceived global quality of life level was 90 (70-99). The altered global quality of life is associated with heart failure after the event (67% vs 17%, p: 0.05) and at a time from the event less than five years (38% vs 6%, p: 0.02). Alterations in mobility are more frequent in women (57%) than in men (12%), p: 0.02, as well as in patients with pain (43%) vs without pain (6%), p: 0.03. Older age is associated with altered self-care (69 years ;58-78; vs 92 years ;87-93, p: 0.013). The delay in treatment (>120 minutes) is associated with alterations in mobility (80% vs 13%, p: 0.005), self-care (60% vs 7%, p: 0, 01) and limitation in usual activities (60% vs 13%, p: 0.03).

Conclusions:

patients with ST-segment elevation myocardial infarction who receive reperfusion treatment with fibrinolytics in our environment may have an alteration in the quality of life. The delay in treatment is associated with long-term altered quality of life.

Palabras clave : Myocardial infarction; Fibrinolytic Agents; Quality of life.

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