PMID- 19030907
OWN - NLM
STAT- MEDLINE
DCOM- 20090518
LR  - 20211020
IS  - 1861-0692 (Electronic)
IS  - 1861-0684 (Linking)
VI  - 98
IP  - 3
DP  - 2009 Mar
TI  - Efficacy of a 24-h primary percutaneous coronary intervention service on outcome 
      in patients with ST elevation myocardial infarction in clinical practice.
PG  - 171-8
LID - 10.1007/s00392-008-0738-6 [doi]
AB  - BACKGROUND: Primary percutaneous coronary intervention (PCI) for ST elevation 
      myocardial infarction (STEMI) improves outcome in comparison to fibrinolysis. 
      However, it is unclear whether patients treated in interventional facilities with 
      24-h primary PCI service have lower rates of adverse events. METHODS: We analyzed 
      data of consecutive patients with STEMI prospectively enrolled in the German 
      Acute Coronary Syndromes registry between July 2000 and November 2002 who were 
      admitted to hospitals with catheterisation laboratory. RESULTS: Overall 6,350 
      patients were divided into two groups: 2,779 (43.8%) were treated in hospitals 
      with and 3,571 (56.2%) without 24-h on-call cardiac catheter laboratories. 83.0% 
      of the patients at facilities with and only 69.9% of the patients at facilities 
      without 24-h PCI service received early reperfusion therapy (P < 0.001). Hospital 
      death (7.4% vs. 9.9%, P < 0.001), non-fatal myocardial reinfarction (2.5% vs. 
      6.4%, P < 0.0001) and stroke (0.3 vs. 1.0%, P < 0.01) occurred significantly less 
      often in patients treated in hospitals with 24-h primary PCI service. After 
      adjustment for the confounding factors in the propensity score analysis the 24-h 
      on-call strategy remained superior for the combined endpoint of death, 
      reinfarction and stroke (OR 0.63, 95% CI 0.54-0.75). CONCLUSIONS: In clinical 
      practice the rate of patients receiving reperfusion therapy was significantly 
      higher in hospitals with 24-h primary PCI service which was associated with an 
      improved in-hospital outcome. Though the data was collected at a time that does 
      not completely represent current clinical practice, these results could have an 
      impact on planning efficient infarct networks in the future.
FAU - Bauer, Timm
AU  - Bauer T
AD  - Herzzentrum Ludwigshafen, Department of Cardiology, Medizinische Klinik B, 
      Bremserstrasse 79, Ludwigshafen, Germany. bauer-timm@gmx.de
FAU - Hoffmann, Rainer
AU  - Hoffmann R
FAU - Junger, Claus
AU  - Junger C
FAU - Koeth, Oliver
AU  - Koeth O
FAU - Zahn, Ralf
AU  - Zahn R
FAU - Gitt, Anselm
AU  - Gitt A
FAU - Heer, Tobias
AU  - Heer T
FAU - Bestehorn, Kurt
AU  - Bestehorn K
FAU - Senges, Jochen
AU  - Senges J
FAU - Zeymer, Uwe
AU  - Zeymer U
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
DEP - 20081122
PL  - Germany
TA  - Clin Res Cardiol
JT  - Clinical research in cardiology : official journal of the German Cardiac Society
JID - 101264123
SB  - IM
MH  - Aged
MH  - *Angioplasty, Balloon, Coronary
MH  - Cardiology Service, Hospital/*organization & administration
MH  - Female
MH  - Germany/epidemiology
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/mortality/*therapy
MH  - Prospective Studies
MH  - Registries
MH  - Secondary Prevention
MH  - Stroke/epidemiology/*etiology
MH  - Time Factors
MH  - Treatment Outcome
EDAT- 2008/11/26 09:00
MHDA- 2009/05/19 09:00
CRDT- 2008/11/26 09:00
PHST- 2008/04/14 00:00 [received]
PHST- 2008/10/10 00:00 [accepted]
PHST- 2008/11/26 09:00 [pubmed]
PHST- 2009/05/19 09:00 [medline]
PHST- 2008/11/26 09:00 [entrez]
AID - 10.1007/s00392-008-0738-6 [doi]
PST - ppublish
SO  - Clin Res Cardiol. 2009 Mar;98(3):171-8. doi: 10.1007/s00392-008-0738-6. Epub 2008 
      Nov 22.