Significant decrease in in-hospital mortality and major adverse cardiac events in Swiss STEMI patients between 2000 and December 2007.

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State: Public
Version: Final published version
Serval ID
serval:BIB_F914D5E94356
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Significant decrease in in-hospital mortality and major adverse cardiac events in Swiss STEMI patients between 2000 and December 2007.
Journal
Swiss medical weekly
Author(s)
Stolt Steiger V., Goy J.J., Stauffer J.C., Radovanovic D., Duvoisin N., Urban P., Bertel O., Erne P.
Working group(s)
AMIS Plus Investigators
ISSN
1424-7860 (Print)
ISSN-L
0036-7672
Publication state
Published
Issued date
08/08/2009
Peer-reviewed
Oui
Volume
139
Number
31-32
Pages
453-457
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
To evaluate the in-hospital outcome of STEMI (ST elevation myocardial infarction) patients admitted to Swiss hospitals between 2000 and December 2007, and to identify the predictors of in-hospital mortality and major cardiac events.
Data from the Swiss national registry AMIS Plus (Acute Myocardial Infarction and Unstable Angina in Switzerland) were used. All patients admitted between January 2000 and December 2007 with STEMI or a new LBBB (left bundle branch block) were included in the registry.
We studied 12 026 STEMI patients admitted to 68 hospitals. The mean age was 64 +/- 13 years and 73% of the patients were male. Incidence of in-hospital death was 7.6% in 2000 and 6% in 2007. Reinfarction fell from 3.7% in 2000 to 0.9% in 2007. Thrombolysis decreased from 40.2% in 2000 to 2% in 2007. Clinical predictors of mortality were: age >65 years, Killips class III or IV, diabetes, Q wave myocardial infarction (at presentation). Patients undergoing percutaneous coronary intervention (PCI) had lower mortality and reinfarction rates (3.9% versus 11.2% and 1.1% versus 3.1% respectively, p <0.001) over time, although their numbers increased from 43% in 2000 to 85% in 2007. Patients admitted to hospitals with PCI facilities had lower mortality than patients hospitalised in hospitals without it, but the demographic characteristics differ widely between the two groups. Both in-hospital mortality and reinfarction decreased significantly over the time, parallel to an increased number of PCI. PCI was also the strongest predictor of survival.
In-hospital mortality and reinfarction rate have decreased significantly in Swiss STEMI patients in the last seven years, parallel to a significant increase in the number of percutaneous coronary interventions in addition to medical therapy. Outcome is not related to the site of admission but to PCI access.

Keywords
Aged, Angioplasty, Balloon, Coronary, Electrocardiography, Female, Hospital Mortality, Humans, Male, Middle Aged, Myocardial Infarction/mortality, Myocardial Infarction/therapy, Recurrence, Stroke/etiology, Switzerland/epidemiology, Thrombolytic Therapy
Pubmed
Create date
11/09/2011 13:43
Last modification date
20/08/2019 16:24
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