PMID- 19685351
OWN - NLM
STAT- MEDLINE
DCOM- 20090923
LR  - 20221212
IS  - 1424-7860 (Print)
IS  - 0036-7672 (Linking)
VI  - 139
IP  - 31-32
DP  - 2009 Aug 8
TI  - Significant decrease in in-hospital mortality and major adverse cardiac events in 
      Swiss STEMI patients between 2000 and December 2007.
PG  - 453-7
AB  - OBJECTIVES: To evaluate the in-hospital outcome of STEMI (ST elevation myocardial 
      infarction) patients admitted to Swiss hospitals between 2000 and December 2007, 
      and to identify the predictors of in-hospital mortality and major cardiac events. 
      METHODS: Data from the Swiss national registry AMIS Plus (Acute Myocardial 
      Infarction and Unstable Angina in Switzerland) were used. All patients admitted 
      between January 2000 and December 2007 with STEMI or a new LBBB (left bundle 
      branch block) were included in the registry. RESULT: We studied 12 026 STEMI 
      patients admitted to 68 hospitals. The mean age was 64 +/- 13 years and 73% of 
      the patients were male. Incidence of in-hospital death was 7.6% in 2000 and 6% in 
      2007. Reinfarction fell from 3.7% in 2000 to 0.9% in 2007. Thrombolysis decreased 
      from 40.2% in 2000 to 2% in 2007. Clinical predictors of mortality were: age >65 
      years, Killips class III or IV, diabetes, Q wave myocardial infarction (at 
      presentation). Patients undergoing percutaneous coronary intervention (PCI) had 
      lower mortality and reinfarction rates (3.9% versus 11.2% and 1.1% versus 3.1% 
      respectively, p <0.001) over time, although their numbers increased from 43% in 
      2000 to 85% in 2007. Patients admitted to hospitals with PCI facilities had lower 
      mortality than patients hospitalised in hospitals without it, but the demographic 
      characteristics differ widely between the two groups. Both in-hospital mortality 
      and reinfarction decreased significantly over the time, parallel to an increased 
      number of PCI. PCI was also the strongest predictor of survival. CONCLUSION: 
      In-hospital mortality and reinfarction rate have decreased significantly in Swiss 
      STEMI patients in the last seven years, parallel to a significant increase in the 
      number of percutaneous coronary interventions in addition to medical therapy. 
      Outcome is not related to the site of admission but to PCI access.
FAU - Stolt Steiger, Valerie
AU  - Stolt Steiger V
AD  - Division of Cardiology, Hopital Cantonal, Fribourg, Switzerland. 
      valerie.stolt@turnover.ch
FAU - Goy, Jean-Jacques
AU  - Goy JJ
FAU - Stauffer, Jean-Christophe
AU  - Stauffer JC
FAU - Radovanovic, Dragana
AU  - Radovanovic D
FAU - Duvoisin, Nicole
AU  - Duvoisin N
FAU - Urban, Philip
AU  - Urban P
FAU - Bertel, Osmund
AU  - Bertel O
FAU - Erne, Paul
AU  - Erne P
CN  - AMIS Plus Investigators
LA  - eng
PT  - Journal Article
PL  - Switzerland
TA  - Swiss Med Wkly
JT  - Swiss medical weekly
JID - 100970884
SB  - IM
MH  - Aged
MH  - Angioplasty, Balloon, Coronary
MH  - Electrocardiography
MH  - Female
MH  - *Hospital Mortality
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/*mortality/therapy
MH  - Recurrence
MH  - Stroke/etiology
MH  - Switzerland/epidemiology
MH  - Thrombolytic Therapy
EDAT- 2009/08/18 09:00
MHDA- 2009/09/24 06:00
CRDT- 2009/08/18 09:00
PHST- 2009/08/18 09:00 [entrez]
PHST- 2009/08/18 09:00 [pubmed]
PHST- 2009/09/24 06:00 [medline]
AID - smw-12607 [pii]
AID - 10.4414/smw.2009.12607 [doi]
PST - ppublish
SO  - Swiss Med Wkly. 2009 Aug 8;139(31-32):453-7. doi: 10.4414/smw.2009.12607.