Outcome of patients with acute myocardial infarction admitted in hospitals with or without catheterization laboratory: results from the HELIOS registry

被引:12
|
作者
Pipilis, Athanasios [1 ]
Andrikopoulos, Georgios [2 ]
Lekakis, John [3 ]
Kalantzi, Kallirroi [4 ]
Kitsiou, Anastasia [5 ]
Toli, Konstantina [6 ]
Floros, Dimitrios [7 ]
Gaita, Dan [8 ]
Karalis, Ioannis [9 ]
Dragomanovits, Spyridon [10 ]
Kalogeropoulos, Petros [11 ]
Synetos, Andreas [12 ]
Koutsogiannis, Nikolaos [13 ]
Stougiannos, Pavlos [14 ]
Antonakoudis, Chariton [10 ]
Goudevenos, John [4 ]
机构
[1] HYGEIA Hosp, Cardiac Dept 1, Athens 15123, Greece
[2] Evangelismos Med Ctr, Athens, Greece
[3] Univ Athens, Attiko Hosp, Athens, Greece
[4] Univ Ioannina Hosp, Athens, Greece
[5] Sismanogleio Hosp, Athens, Greece
[6] Chalkida Hosp, Chalkida, Greece
[7] Alexandroupoli Hosp, Alexandroupolis, Greece
[8] Timisoara Univ, Timisoara, Romania
[9] Univ Crete Hosp, Iraklion, Greece
[10] Asklepie Hosp, Athens, Greece
[11] 7th IKA Hosp, Athens, Greece
[12] Univ Athens, Hippokrate Hosp, GR-10679 Athens, Greece
[13] Univ Patra Hosp, Patras, Greece
[14] Korinthos Hosp, Corinth, Greece
关键词
acute myocardial infarction; catheterization laboratory; noninvasive hospitals; registry; ACUTE CORONARY SYNDROMES; EUROPEAN-SOCIETY; ELDERLY-PATIENTS; UNITED-STATES; MANAGEMENT; CANADA; EPIDEMIOLOGY;
D O I
10.1097/HJR.0b013e32831e954e
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Aims To compare the treatment and outcomes of myocardial infarction patients in hospitals with and without catheterization laboratory. Methods and results 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). Conclusion 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. Eur J Cardiovasc Prev Rehabil 16:85-90 (C) 2009 The European Society of Cardiology
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收藏
页码:85 / 90
页数:6
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