Τίτλος:
Outcome of patients with acute myocardial infarction admitted in hospitals with or without catheterization laboratory: Results from the HELIOS registry
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
To compare the treatment and outcomes of myocardial infarction patients in hospitals with and without catheterization laboratory. The Hellenic Infarction Observation Study was a countrywide registry of acute myocardial infarction, conducted during 2005-2006. The registry enrolled 1840 patients with myocardial infarction from 31 hospitals with a proportional representation of all types of hospitals and of all geographical areas. Out of these patients, 645 (35%) were admitted in 11 hospitals with and 1195 (65%) in 20 hospitals without catheterization laboratory. Patients admitted in hospitals with catheterization laboratory in comparison with patients admitted in hospitals without were younger (66 ± 14 vs. 68 ±13, P < 0.004) with less diabetes (27 vs. 33%, P < 0.001), but without other baseline differences (female 27 vs. 25%, prior myocardial infarction 20 vs. 17%, Killip class >1 22 vs. 23%). Reperfusion rates for ST-segment elevation myocardial infarction were 67% (43% lytic, 24% primary percutaneous coronary interventions) versus 56% (55% lytic, 1% percutaneous coronary interventions; P < 0.01). In-hospital outcomes in hospitals with versus in hospitals without laboratory were: mortality 6.5 versus 8.3% (NS), stroke 2.2 versus 1.1% (NS), major bleeding 1.1 versus 0.6% (NS), and heart failure 11 versus 16% (P < 0.01). In multivariate regression analysis, being admitted in a hospital without catheterization laboratory was not an independent predictor of increased in-hospital mortality (odds ratio = 1.18, 95% confidence interval: 0.72-1.93, P = 0.505). Although the majority of acute myocardial infarction patients was admitted in hospitals without catheterization laboratory, these patients do not have a survival disadvantage, provided they are treated with lytic therapy, medical secondary prevention drugs, and eventual revascularization according to current guidelines. © 2009, European Society of Cardiology. All rights reserved.
Συγγραφείς:
Pipilis, A.
Andrikopoulos, G.
Lekakis, J.
Kalantzi, K.
Kitsiou, A.
Toli, K.
Floras, D.
Gaita, D.
Karalis, I.
Dragomanovits, S.
Kalogeropoulos, P.
Synetos, A.
Koutsogiannis, N.
Stougiannos, P.
Antonakoudis, C.
Goudevenos, J.
Περιοδικό:
European Journal of Preventive Cardiology
Λέξεις-κλειδιά:
acetylsalicylic acid; angiotensin receptor antagonist; antithrombocytic agent; beta adrenergic receptor blocking agent; calcium channel blocking agent; clopidogrel; dipeptidyl carboxypeptidase inhibitor; fibrinogen receptor antagonist; heparin; hydroxymethylglutaryl coenzyme A reductase inhibitor; low molecular weight heparin; nitric acid derivative; anticoagulant agent, acute heart infarction; adult; aged; angina pectoris; article; bleeding; controlled study; coronary artery bypass surgery; diabetes mellitus; female; groups by age; heart catheterization; heart failure; heart muscle reperfusion; heart muscle revascularization; hospital admission; hospital laboratory; human; major clinical study; male; mortality; multivariate logistic regression analysis; outcome assessment; percutaneous coronary intervention; predictor variable; priority journal; sex ratio; shock; ST segment elevation; stroke; angina pectoris; clinical trial; drug utilization; Greece; health care facility; heart failure; heart infarction; hospitalization; multicenter study; outcome assessment; recurrent disease; register; shock; statistics; stroke; transluminal coronary angioplasty, Adrenergic beta-Antagonists; Aged; Angina Pectoris; Angioplasty, Transluminal, Percutaneous Coronary; Angiotensin II Type 1 Receptor Blockers; Angiotensin-Converting Enzyme Inhibitors; Anticoagulants; Drug Utilization; Female; Greece; Health Facilities; Heart Catheterization; Heart Failure; Heparin; Hospitalization; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Male; Myocardial Infarction; Myocardial Reperfusion; Outcome Assessment (Health Care); Platelet Aggregation Inhibitors; Recurrence; Registries; Shock; Stroke
DOI:
10.1097/HJR.0b013e32831e954e
