Diagnosis and interventional treatment in patients of the General Calixto Garcia Hospital

Abstract

Introduction: The diagnosis and interventional treatment is a distance service in the developing world, in hospitals that do not have interventional cardiology services. This is the case of the Calixto Garcia Hospital, where patients are referred to two nearby hospitals.

Objectives: To characterize the interventional treatment of patients admitted to the coronary care ward of the above hospital.

Method: A descriptive cross-sectional study was conducted from January 2003 to December 2009. The medical records and the databases of the Cardiac Catheterization and Interventional Cardiology Departments from the Institute of Cardiology and Cardiovascular Surgery and the Carlos J. Finlay Military Hospital were reviewed.

Results: 841 coronary angiograms were performed. There was a predominance of males with 559 cases (66.5 %), the mean age was 58 years, the most common risk factors included hypertension 613 (72.9%), smoking 277 (32.9%), dyslipidemia 164 (19.5%) and diabetes mellitus 138 (16.4%). Angiographically significant lesions were found in 65% of patients; 272 patients (32.3%) had 1-vessel disease and 276 (32.8%) had 2 and 3-vessel disease. A total of 327 (38.9%) coronary angioplasties were performed, predominantly in men 239 (73%), with a similar behavior of the risk factors. The most common clinical diagnoses in this group included acute coronary syndrome without ST segment elevation 145 (44.3%), chronic stable angina 106 (32.4%) and acute coronary syndrome with ST segment elevation 61 (18.7 %). The most affected and treated artery was the left anterior descending artery. The 3.0 x 18 mm metal stent Apolo was the most used stent. The procedure was successful in 95.7 % of cases.

Conclusions: Percutaneous treatment is a valid option for patients admitted to cen-ters that do not have the interventional cardiology service.