Primary percutaneous intervention of ST-elevation myocardial infarction in Austria: Results from the Austrian acute PCI registry 2005-2007

被引:1
|
作者
Doerler, Jakob [2 ]
Alber, Hannes Franz [2 ]
Altenberger, Johann [3 ]
Bonner, Gerhard [1 ]
Benzer, Werner [4 ]
Grimm, Georg [5 ]
Huber, Kurt [6 ]
Kaltenbach, Lalit [7 ]
Pfeiffer, Karl-Peter [7 ]
Schuchlenz, Herwig [8 ]
Siostrzonek, Peter [9 ]
Zenker, Gerald [10 ]
Pachinger, Otmar [2 ]
Weidinger, Franz [1 ]
机构
[1] Hosp Rudolfstiftung, Dept Med 2, A-1030 Vienna, Austria
[2] Innsbruck Med Univ, Dept Internal Med 3, Innsbruck, Austria
[3] Paracelsus Med Univ Salzburg, Dept Internal Med 2, Salzburg, Austria
[4] LKH Feldkirch, Dept Intervent Cardiol, Feldkirch, Austria
[5] LKH Klagenfurt, Dept Med 2, Klagenfurt, Austria
[6] Wilhelminenspital Stadt Wien, Dept Med 3, Vienna, Austria
[7] Innsbruck Med Univ, Dept Med Stat Informat & Hlth Econ, Innsbruck, Austria
[8] LKH Graz W, Dept Cardiol & Intens Care Med, Graz, Austria
[9] Krankenhaus Barmherzige Schwestern, Dept Internal Med & Cardiol, Linz, Austria
[10] LKH Bruck, Dept Internal Med, Bruck, Austria
关键词
Primary PCI; ST-elevation myocardial infarction; registry; TO-BALLOON TIME; CORONARY INTERVENTION; REPERFUSION THERAPY; TREATMENT DELAYS; MORTALITY; TRENDS; IMPACT; ONSET; IMPLEMENTATION; ANGIOPLASTY;
D O I
10.1007/s00508-010-1352-y
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
BACKGROUND: Primary percutaneous coronary intervention (PPCI) has become the preferred reperfusion strategy in ST-elevation myocardial infarction (STEMI). Implementation of networks of care and registries providing continuous quality assessment are key components for optimal management in patients with STEMI. AIM: To analyze procedural success and in-hospital outcome of interventional therapy of STEMI in Austria. METHODS: We evaluated a total number of 4016 consecutive STEMI patients registered in the first three years after implementation of the Austrian acute PCI registry in January 2005. RESULTS: The rate of PPCI as an indication for acute coronary intervention increased from 83.5% in 2005 to 92.4% in 2007 (P < 0.0001). During this period the median door-to-balloon time decreased from 60.0 (40.0-90.0) min to 53.0 (30.0-80.0) min (P = 0.012). The percentage of patients receiving adequate adjunctive antithrombotic therapy with ASA/heparin and clopidogrel significantly increased (78.8-85.1% and 67.8-90.3%, respectively; P < 0.001). Overall in-hospital mortality was 9.6% in rescue PCI, 6.4% in facilitated PCI and 5.1% in PPCI. On multivariate analysis, cardiogenic shock (OR: 20.21, 95% CI: 12.21-33.44, P < 0.001), resuscitation (OR: 2.62, 95% CI: 1.47-4.69, P = 0.01), age (OR: 1.04, 95% CI: 1.02-1.06, P < 0.001) and angiographic success (OR: 5.93, 95% CI: 3.33-10.57, P < 0.001) were independent predictors of in-hospital death. CONCLUSION: Continuous nationwide efforts to establish regional networks for STEMI treatment in the years 2005-2007 led to a decrease in door-to-balloon time, improved adjunctive antithrombotic therapy and an in-hospital mortality of 5%. Results of interventional STEMI treatment in Austria are in accordance with current guidelines and with other contemporary registries.
引用
收藏
页码:220 / 228
页数:9
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