Læknablaðið - 01.02.1973, Page 15

LÆKNABLAÐIÐ
7
Nýjum starfskröftum var kennd endur-
lífgunaraðgerð við komu á deildina, og
gengu þær yfirleitt allvel, þótt árangur
væri ekki meiri en raun ber vitni.17
Að vonum var lyfjameðferð gegn hjart-
sláttaróreglu algengari á þessu tímabili,
en því, sem á undan fór, enda tók áhugi
manna á fyrirbyggjandi meðferð mjög að
aukast um þetta leyti.17 Eins og áður var
segavörnum alltaf beitt, nema sérstök rök
mæltu gegn því.
Ekki þykir ástæða til að fjölyrða um
hina einstöku áhættuþætti sbr. fyrri rann-
sókn.17 Hvað reykingar snertir, voru nið-
urstöður mjög á sama veg og fyrr, þ. e. a. s.
dánartala reykingamanna var lægri og
meðalaldur þeirra sömuleiðis. Um túlkun
á þessum atriðum vísast enn í fyrri grein
okkar og bent er á erlendar niðurstöður
varðandi þessi atriði.2 3 6 10 17
LOKAORÐ
Dánartala er svipuð fyrst eftir og fyrir
opnun hjartagæzludeildar Landspítalans.
Eftir stofnun deildarinnar koma sjúkling-
ar fyrr inn til meðferðar. Lyfjameðferð
gegn hjartsláttaróreglu er meiri en áður.
Hjartadá er sjaldgæfara en fyrr.
HEIMILDIR
1. Bainton, C. R. & Peterson, D. R. Deaths
from coronary heart disease in persons
fifty years of age and younger. New Eng.
J. Med. 268:569-575. 1963.
2. Brett, G. Z. & Benjamin, B. Smoking habits
of men employed in industry and mortality.
Brit. Med. J. 3:82-85. 1968.
3. Doyle, J. T. & al. Cigarette smoking and
coronary heart disease. Combined experi-
ence of the Albany and Framingham
studies. New Eng. J. Med. 266:796-801.
1962.
4. Eddy, J. D. & Mackinnon, J. A coronary
care unit in a general medical ward. Brit.
Heart J. 32:733-737. 1970.
5. Fox, S. M. Policy and future of intensive
coronary care, í Acute myocardial infarc-
tion (ed. by Julian, D. G. & Oliver, M. F.),
328-335. [Livingstone]. Edinburgh 1968.
6. Frank, C. W. & al. Myocardial infarction
in men. Role of physical activity and smok-
ing in incidence and mortality. J.A.M.A.
198:1241-1245. 1966.
7. Goble, A. J. & al. Mortality reduction in a
coronary care unit. Brit. Med. J. 1:1005-
1009. 1966.
8. Halperin, M. & al. Sample sizes for medical
trials with special references to longterm
therapy. J. Chron. Dis. 21:13-24. 1968.
9. Hubner, P. J. B. & al. Value of routine
cardiac monitoring in the management of
acute myocardial infarction outside a cor-
onary care unit. Brit. Med. J. 1:815-817.
1969.
10. Jenkins, C. D. & al. Cigarette smoking. Its
relationship to coronary heart disease and
related risk factors in Western collabora-
tive group study. Circulation 38:1140-1155.
1968.
11. Klaus, A. P. & al. Evaluating coronary care
units. Amer. Heart J. 79:471-480. 1970.
12. McNeilly, R. H. & Pemberton, J. Duration
of heart attack in 998 total cases of coron-
ary artery disease and its relation to pos-
sible cardiac resuscitation. Brit. Med. J.
3:139-142. 1968.
13. Most, A. S. & Peterson, D. R. Myocardial
infarction surveillance in a metropolitan
community. J.A.M.A. 208:2433-2438. 1969.
14. Nachlas, M. M. & Miller, D. I. Closed-chest
cardiac resuscitation in patients with acute
myocardial infarction. Amer. Heart J. 69:
448-459. 1965.
15. Reid, D. D. The design and conduct of
clinical trials in myocardial infarction. Cir-
culation 39-40:(suppl. 4) IV-91-IV-98. 1969.
16. Sloman, G. & al. Coronary care unit: A re-
view of 300 patients monitored since 1963.
Amer. Heart J. 75:140-143. 1968.
17. Þorsteinsson, S. & al. 151 sjúklingur með
kransæðastiflu á lyflæknisdeild Landspítal-
ans 1966-1968. Læknablaðið 57:255. 1971.
ENGLISH SUMMARY
A Coronary Care Unit was started in 1969
at the University Hospital of Iceland, Reykja-
vik. When reviewing the mortality and com-
plications of myocardial infarction before and
after that year we have defined the interval
between 1/1 1969 and 1/4 1970 as a transitional
period during which some of the characteristics
of the usual CCUs had been adopted but others
not.
Results from the pre-CCU period have al-
ready been published. During the transitional
period 94 patients with symptoms, biochemical
and electrocardiographic findings satisfying the
WHO criteria for the diagnosis of myocardial
infarction were admitted, 22 females and 72
males. The overall mortality was 23,4% which
is similar to the pre-CCU period (21%). The
lower mortality which was expeeted with the
advent of increased safety and prophylactic
measures was possibly nullified by the fact
that the patients were admitted earlier after
the onset of acute symptoms, 55,2% in the
first 6 hours as compared with 46% in the
pre-CCU period, and the slightly higher in-
cidence of previous infarcts,
The majority of the patients were given
anticoagulants and 40 received some antiar-
rythmic agents.