ACUTE INFARCTION WITH ST-Segment Elevation: PRIMARY PCI IN THE FIRST 6 HOURS VS. EARLY THROMBOLYSIS VS. CONVENTIONAL THERAPY

Introduction : Primary percutaneous coronary intervention (pPCI) is, currently, the treatment we choose for patients with ST segment elevation myocardial infarction (STEMI). The thrombolytic treatment is an appreciated alternative when the reperfusion therapy is not available in due time. Aim: our study aims to assess both the costs and the benefits of the patients with IMA with ST segment elevation treated with Primary coronary intervention (PCI) associated with medical therapy vs. Thrombolytic therapy vs. Conventional therapy. Methods: 625 patients with acute ST – elevation myocardial infarction admitted in our clinic from January 2010 until May 2011 were analyzed. In carrying out the cost analysis we took into account the direct medical costs and, in order to assess the benefits of these therapies the major complications were analyzed. Results: the c osts of therapy for the acute myocardial infarction with ST segment elevation in the three different therapeutic approaches are different, as of 4238 ron for primary PCI, 5338 ron for thrombolytic therapy and 2652 ron for conventional therapy. The interventional therapy benefits are significant for Angor post-infarction and hospital mortality, other complications such as major bleeding and reinfarction occuring at values ​​ much higher than thrombolytic and conventional therapy. Key-words: percutaneous coronary intervention, thrombolitic treatment, cost-effectiveness.