Universal reperfusion therapy can be implemented: lessons from 20 years of management of patients admitted within 6 hours of symptom onset with ST-segment elevation acute myocardial infarction

Autor: Jean-Michel Juliard, Agnès Greffet, Alexis Burnod, Laurent J. Feldman, Hakim Benamer, Dominique Himbert, Gregory Ducrocq, Olivier Boudvillain, Eric Garbarz, Pierre Aubry, Didier Tchetche, Jean-Louis Golmard, Philippe Gabriel Steg, Frédéric Lapostolle
Rok vydání: 2008
Předmět:
Male
Time Factors
Myocardial Infarction
ST segment
Thrombolytic Therapy
Myocardial infarction
Hospital Mortality
Longitudinal Studies
Angioplasty
Balloon
Coronary
Aged
80 and over
education.field_of_study
Glycoprotein IIb/IIIa inhibitors
Cardiogenic shock
ST elevation
Angioplastie primaire
General Medicine
Middle Aged
Thrombolysis
Treatment Outcome
Practice Guidelines as Topic
Cardiology
Female
Stents
Cardiology and Cardiovascular Medicine
medicine.drug
Adult
medicine.medical_specialty
Fibrinolyse
Stents coronaires
Population
Shock
Cardiogenic
Infarctus du myocarde
Risk Assessment
Young Adult
Reperfusion therapy
Internal medicine
Coronary Circulation
medicine
Humans
cardiovascular diseases
education
Primary angioplasty
Aged
Quality of Health Care
business.industry
medicine.disease
Survival Analysis
Inhibiteurs des récepteurs GP IIb/IIIa
Logistic Models
Conventional PCI
business
Platelet Aggregation Inhibitors
Zdroj: Archives of cardiovascular diseases. 102(4)
ISSN: 1875-2136
Popis: SummaryAimTo describe longitudinal trends in patients’ characteristics, management and hospital outcomes over 20 years of therapy for ST-segment elevation myocardial infarction (STEMI).MethodsFrom 1988 to 2007, 2100 consecutive patients with STEMI were admitted within 6hours of symptom onset to a centre with a systematic reperfusion policy. The population was divided into three periods 1988–1996, 1996–2001 and 2001–2007.ResultsThe baseline risk of mortality increased over time (p=0.02). Use of primary PCI increased and the proportion not receiving reperfusion therapy decreased (from 11.4 to 4.2%, p=0.0001). Adjunctive use of stents and glycoprotein IIb/IIIa antagonists increased. The proportion of patients achieving acute TIMI-3 flow in the infarct artery increased (81 to 92%, p=0.001), while time from symptom onset to reperfusion decreased (240 to 205min, p
Databáze: OpenAIRE
Externí odkaz: