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Perfil epidemiológico e fatores associados ao tipo de enfarte em adultos submetidos a angioplastia coronária primária
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Abstract(s)
O presente relatório descreve o percurso desenvolvido durante os estágios no Laboratório de Hemodinâmica, no Serviço de Urgência Polivalente e nos Cuidados Intensivos, integrados na componente profissionalizante do Curso de Mestrado em Enfermagem Médico-Cirúrgica, área da Pessoa em Situação Crítica (CMEMC-EPSC), da Escola Superior de Saúde de Bragança. Numa segunda parte foca-se no estudo empírico realizado numa Unidade Hospitalar do interior norte de Portugal, centrado na caraterização epidemiológica dos adultos submetidos a angioplastia coronária primária e
nos fatores associados à evolução do enfarte.
Objetivos: Caracterizar o perfil sociodemográfico dos adultos submetidos a angioplastia coronária primária; descrever os fatores de risco cardiovasculares presentes nesta população; caracterizar o perfil clínico, eletrocardiográfico e angiográfico dos doentes incluídos no estudo; analisar a associação entre variáveis sociodemográficas, clínicas e
angiográficas com os tipos de enfarte.
Métodos: Estudo observacional, retrospetivo, descritivo e correlacional numa amostra de 363 doentes com enfarte agudo do miocárdio com elevação do segmento ST (EAMcST), entre 1 de janeiro de 2022 e 31 de dezembro de 2023. Utilizou-se um instrumento de recolha de dados estruturado através da plataforma CardioBase® e análise dos processos
clínicos.
Resultados: A média etária foi de 67,96±12,31 anos, com predominância masculina (69,4%) e maior prevalência de doentes em 2023 (53,2%). O acesso radial direito foi o mais utilizado (87,4%) e a artéria descendente anterior a mais implicada (36,8%).
Verificou-se associação significativa entre hipertensão arterial e a artéria culpada (p=0,008). O tempo médio entre início dos sintomas e intervenção foi de 7h12min, com um tempo médio do procedimento de 42 minutos.
Conclusão: O estudo confirma a relevância da angioplastia coronária primária no EAMcST e a importância do acesso radial, destacando a associação entre hipertensão arterial e artéria responsável pela oclusão. Os estágios contribuíram para o desenvolvimento de competências especializadas em EMC-EPSC, com foco na humanização, controlo de fatores de risco e cuidados personalizados.
This report describes the learning path developed during internships in the Hemodynamics Laboratory, the Emergency Department, and the Intensive Care Unit, as part of the professional component of the Master’s Degree in Medical-Surgical Nursing, in the area of the Person in Critical Condition (CMEMC-EPSC), at the Escola Superior de Saúde de Bragança. The second part presents the empirical study conducted at a hospital unit in northern Portugal, focusing on the epidemiological characterization of adults undergoing primary coronary angioplasty (PCA) and the factors associated with myocardial infarction outcomes. Objectives: To characterize the sociodemographic profile of adults undergoing primary coronary angioplasty; to describe the cardiovascular risk factors present in this population; to characterize the clinical, electrocardiographic, and angiographic profile of the patients included in the study; and to analyze the association between sociodemographic, clinical, and angiographic variables and the types of myocardial infarction. Methods: An observational, retrospective, descriptive, and correlational study was conducted on a sample of 363 patients diagnosed with STEMI and treated with PCA between January 1, 2022, and December 31, 2023. Data collection was performed using a structured tool, based on the CardioBase® platform and the analysis of clinical records. Results: The mean age was 67.96 ± 12.31 years, with a predominance of male patients (69.4%) and a higher prevalence of cases in 2023 (53.2%). The right radial access was the most frequently used approach (87.4%), and the left anterior descending artery was the most affected (36.8%), followed by the right coronary artery (31.2%). A statistically significant association was observed between arterial hypertension and the culprit artery (p=0.008). The mean time from symptom onset to intervention was 7h12min, and the mean procedural time was 42 minutes. Conclusion: The study confirmed the relevance of PCA in STEMI management and the superiority of radial access. A significant association was observed between arterial hypertension and the culprit artery, reinforcing the need for preventive strategies and early referral. The internships were crucial in developing advanced skills in Medical-Surgical Nursing for critically ill patients, with a focus on close monitoring, complication management, humanized care, and early rehabilitation.
This report describes the learning path developed during internships in the Hemodynamics Laboratory, the Emergency Department, and the Intensive Care Unit, as part of the professional component of the Master’s Degree in Medical-Surgical Nursing, in the area of the Person in Critical Condition (CMEMC-EPSC), at the Escola Superior de Saúde de Bragança. The second part presents the empirical study conducted at a hospital unit in northern Portugal, focusing on the epidemiological characterization of adults undergoing primary coronary angioplasty (PCA) and the factors associated with myocardial infarction outcomes. Objectives: To characterize the sociodemographic profile of adults undergoing primary coronary angioplasty; to describe the cardiovascular risk factors present in this population; to characterize the clinical, electrocardiographic, and angiographic profile of the patients included in the study; and to analyze the association between sociodemographic, clinical, and angiographic variables and the types of myocardial infarction. Methods: An observational, retrospective, descriptive, and correlational study was conducted on a sample of 363 patients diagnosed with STEMI and treated with PCA between January 1, 2022, and December 31, 2023. Data collection was performed using a structured tool, based on the CardioBase® platform and the analysis of clinical records. Results: The mean age was 67.96 ± 12.31 years, with a predominance of male patients (69.4%) and a higher prevalence of cases in 2023 (53.2%). The right radial access was the most frequently used approach (87.4%), and the left anterior descending artery was the most affected (36.8%), followed by the right coronary artery (31.2%). A statistically significant association was observed between arterial hypertension and the culprit artery (p=0.008). The mean time from symptom onset to intervention was 7h12min, and the mean procedural time was 42 minutes. Conclusion: The study confirmed the relevance of PCA in STEMI management and the superiority of radial access. A significant association was observed between arterial hypertension and the culprit artery, reinforcing the need for preventive strategies and early referral. The internships were crucial in developing advanced skills in Medical-Surgical Nursing for critically ill patients, with a focus on close monitoring, complication management, humanized care, and early rehabilitation.
Description
Keywords
Angioplastia coronária primária Enfarte agudo do miocárdio com elevação do segmento ST Artérias coronárias obstruídas Enfermagem médico cirúrgica