Inhalt des Dokuments
Improved therapy and outcome for patients with acute myocardial infarction - Data of the Berlin Myocardial Infarction Registry from 1999 to 2004
Autor | Maier B, Thimme
W, Schoeller R, Fried A, Behrens S, Theres
H |
Verlag | International Journal of
Cardiology 130(2): p.211-219 |
Zusammenfassung
Background
Guidelines for
treatment of patients with myocardial infarction (MI) have been
regularly updated. In addition, a new definition for acute MI has been
recently established. The aim of our study was to evaluate development
of treatment and effects on patient outcome.
Methods
We prospectively collected data from
MI patients who were treated in 22 hospitals in Berlin, Germany,
during the years 1999 to 2004. In the study we consecutively included
6080 MI patients presenting with (STEMI, n=4314) and without
persistent ST-segment elevation (NSTEMI, n=1766).
Results
STEMI and NSTEMI patients showed an
increase over time in arterial hypertension, smoking,
hypercholesterolaemia, history of congestive heart failure, and renal
failure.
The application of acute percutaneous coronary
intervention increased from 15.3% to 62.3% (p<0.001) for NSTEMI and
from 24.7% to 71.8% (p<0.001) for STEMI patients.
Concomitant
therapy with beta-blockers, ACE inhibitors, statins, GP IIb/IIIa, and
aspirin increased in parallel in both groups.
The decrease in
hospital mortality was more pronounced for NSTEMI (13.5% vs. 4.6%,
p<0.001) than with STEMI patients (13.0% vs. 9.4%, p=0.005).
Conclusions
Adherence to guidelines has
led to a higher level of hospital care for NSTEMI and STEMI patients.
Hospital mortality decreased for both groups, with a greater impact on
NSTEMI patients.
icle/S0167-5273(07)01805-0/abstract