The mortality rates in registries of patients with STEMI are highly affected by inclusion criteria and population characteristics

Autor: Pierre Bernard Petitcolin, Valérie Pradel, Henri Karam, Julien Magne, Victor Aboyans, Pierre A. Pages, Elie Martins, Gilles Faugeras, Nicole Darodes, Eric Fleurant, Patrice Virot, Virginie Rousselle, Sebastien Bosle, Dominique Cailloce
Přispěvatelé: Service de cardiologie [CHU Limoges], CHU Limoges, Neuroépidémiologie Tropicale (NET), CHU Limoges-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), Université de Limoges (UNILIM)-Université de Limoges (UNILIM), Centre Hospitalier Brive-la-Gaillarde, Service des urgences [CHU Limoges], Clinical sciences
Jazyk: angličtina
Rok vydání: 2021
Předmět:
medicine.medical_specialty
ST Elevation Myocardial Infarction/diagnosis
Population
030204 cardiovascular system & hematology
registry
France/epidemiology
03 medical and health sciences
0302 clinical medicine
Percutaneous Coronary Intervention
Internal medicine
medicine
Humans
cardiovascular diseases
030212 general & internal medicine
Myocardial infarction
Registries
10. No inequality
education
education.field_of_study
business.industry
Mortality rate
methodology
General Medicine
Middle Aged
medicine.disease
mortality
3. Good health
ST-segment elevation myocardial infarction
surgical procedures
operative
Treatment Outcome
ST Elevation Myocardial Infarction
[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie
France
business
Cardiology and Cardiovascular Medicine
Inclusion (education)
Zdroj: Acta Cardiologica
Acta Cardiologica, Acta Medica Belgica, 2021, 76 (5), pp.504-512. ⟨10.1080/00015385.2020.1848970⟩
ISSN: 0001-5385
DOI: 10.1080/00015385.2020.1848970⟩
Popis: International audience; Background: Different mortality rates are reported in registries of patients with ST-segment elevation myocardial infarction (STEMI), but comparisons between registries are challenging. Aims: To determine whether the higher mortality rate in our regional French registry (SCALIM) is related to different inclusion criteria and demographic characteristics. Methods: The SCALIM registry included all patients with STEMI within the first 24 h in the region of Limousin, France (06/2011-01/2015). To compare mortality rates with other contemporary registries in France and European neighbouring countries, the others' inclusion criteria were applied to the SCALIM registry. Results: Among 1501 patients included, in-hospital and 1-month mortality were 8.2% and 8.8% respectively, significantly higher than many other registries. The use of inclusion criteria from EMUST (France), MINAP (UK) or LOMBARDIMA (Italy) markedly decreased the number of enrolled patients by 64%, 36%, and 21%, respectively. When those inclusion criteria were applied to the SCALIM registry, difference in in-hospital and 1-month mortality rates between other registries and ours remained significant. In the multivariate analysis, age, initial acute pulmonary oedema (Killip class ≥2), complication occurring before percutaneous coronary intervention, absence of transfer to an interventional cardiology centre for primary angioplasty and lack of reperfusion therapy within 12 h were associated with higher risk of 1-month mortality (all p < 0.05). Age (65 versus 63.3 years, p < 0.001) was higher and reperfusion rate (84.2 versus 74.7%, p < 0.001) was significantly lower in SCALIM than FAST-MI, the national French registry on STEMI patients. Interestingly, the 3% of patients included in SCALIM who would be excluded from FAST-MI registry had 91% mortality at one month. Conclusion: Higher mortality rate in our regional SCALIM registry is in part due to differences in inclusion criteria and demographic data. Consensus should be made to harmonise inclusion criteria in STEMI registries for the sake of comparability.
Databáze: OpenAIRE
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