Inpatient versus outpatient onsets of acute myocardial infarction.

Détails

ID Serval
serval:BIB_9E4B92E5B96B
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Inpatient versus outpatient onsets of acute myocardial infarction.
Périodique
European journal of internal medicine
Auteur⸱e⸱s
Erne P., Bertel O., Urban P., Pedrazzini G., Lüscher T.F., Radovanovic D.
Collaborateur⸱rice⸱s
AMIS Plus Investigators
Contributeur⸱rice⸱s
Lessing P., Hess F., Simon R., Hangartner P.J., Hufschmid U., Hornig B., Jeger R., Trummler S., Windecker S., Rueff T., Loretan P., Roethlisberger C., Mang G., Ryser D., Kistler W., Stäuble S., Freiwald G., Schmid H.P., Bietenhard K., Roffi M., Schönenberger R., Schmidli M., Federspiel B., Weiss E.M., Weber K., Zender H., Poepping I., Hugi A., Koltai E., Iglesias J.F., Pedrazzini G., Erne P., Erne P., Cuculi F., Heimes T., Pagnamenta A., Urban P., Stettler C., Repond F., Widmer F., Heimgartner C., Polikar R., Bassetti S., Iselin H.U., Giger M., Egger P., Kaeslin T., Fischer A., Herren T., Girod G., Vogel R., Niggli B., Rickli H., Yoon S., Nossen J., Stoller U., Bächli E., Eriksson U., Fischer T., Peter M., Gasser S., Fatio R., Bertel O., Maggiorini M., Eberli F., Christen S.
ISSN
1879-0828 (Electronic)
ISSN-L
0953-6205
Statut éditorial
Publié
Date de publication
07/2015
Volume
26
Numéro
6
Pages
414-419
Langue
anglais
Notes
Publication types: Comparative Study ; Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Résumé
There are few studies on patients suffering acute myocardial infarction (AMI) when already in hospital for other reasons; therefore, this study aimed to compare patients with in-hospital-onset AMI admitted for either medical or surgical reasons versus patients with outpatient-onset AMI.
Patients enrolled in the AMIS Plus registry from 2002 to 2014 were analyzed. The main endpoint was in-hospital mortality.
Among 35,394 AMI patients, 356 (1%) had inpatient-onset AMI following hospital admission due to other pathologies (surgical 175, non-surgical 181). These patients were older (74 vs. 66 years; P<0.001), more often female (35% vs. 27%; P<0.001), had less frequently ST-elevation myocardial infarction (35.5% vs. 55.5%; P<0.001), but higher risk profiles: hypertension (83% vs. 62%; P<0.001), diabetes (28% vs. 20%; P=0.001), known coronary artery disease (54% vs. 35%; P<0.001), and more comorbidities (Charlson Comorbidity Index above 1 in 51% vs. 22%; P<0.001) than those with outpatient-onset AMI. Percutaneous coronary intervention was less frequently applied (OR 0.45; 95% CI 0.36-0.57), and they were less likely to be treated with aspirin (OR 0.43; 95% CI 0.37-0.59), P2Y12 blockers (OR 0.42; 0.34-0.52) or statins (OR 0.51; 95% CI 0.41-0.63). Crude mortality was higher (14.3% vs. 5.5%; P<0.001) and inpatient-onset AMI was an independent predictor of in-hospital mortality (OR 2.35; 95% CI 1.63-3.39; P<0.001).
Patients with in-hospital-onset AMI were at greater risk of death than those with outpatient-onset AMI. More work is needed to improve the identification of hospitalized patients at risk of AMI in order to provide the appropriate management.

Mots-clé
Aged, Female, Guideline Adherence/statistics & numerical data, Hospital Mortality, Hospitalization/statistics & numerical data, Humans, Inpatients/statistics & numerical data, Male, Myocardial Infarction/mortality, Myocardial Infarction/therapy, Outpatients/statistics & numerical data, Prospective Studies, Risk Factors
Pubmed
Création de la notice
05/02/2017 18:37
Dernière modification de la notice
20/08/2019 16:04
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