PMID- 19933242
OWN - NLM
STAT- MEDLINE
DCOM- 20110428
LR  - 20220409
IS  - 1522-9645 (Electronic)
IS  - 0195-668X (Print)
IS  - 0195-668X (Linking)
VI  - 31
IP  - 8
DP  - 2010 Apr
TI  - Reperfusion therapy for ST elevation acute myocardial infarction in Europe: 
      description of the current situation in 30 countries.
PG  - 943-57
LID - 10.1093/eurheartj/ehp492 [doi]
AB  - AIMS: Patient access to reperfusion therapy and the use of primary percutaneous 
      coronary intervention (p-PCI) or thrombolysis (TL) varies considerably between 
      European countries. The aim of this study was to obtain a realistic contemporary 
      picture of how patients with ST elevation myocardial infarction (STEMI) are 
      treated in different European countries. METHODS AND RESULTS: The chairpersons of 
      the national working groups/societies of interventional cardiology in European 
      countries and selected experts known to be involved in the national registries 
      joined the writing group upon invitation. Data were collected about the country 
      and any existing national STEMI or PCI registries, about STEMI epidemiology, and 
      treatment in each given country and about PCI and p-PCI centres and procedures in 
      each country. Results from the national and/or regional registries in 30 
      countries were included in this analysis. The annual incidence of hospital 
      admission for any acute myocardial infarction (AMI) varied between 90-312/100 
      thousand/year, the incidence of STEMI alone ranging from 44 to 142. Primary PCI 
      was the dominant reperfusion strategy in 16 countries and TL in 8 countries. The 
      use of a p-PCI strategy varied between 5 and 92% (of all STEMI patients) and the 
      use of TL between 0 and 55%. Any reperfusion treatment (p-PCI or TL) was used in 
      37-93% of STEMI patients. Significantly less reperfusion therapy was used in 
      those countries where TL was the dominant strategy. The number of p-PCI 
      procedures per million per year varied among countries between 20 and 970. The 
      mean population served by a single p-PCI centre varied between 0.3 and 7.4 
      million inhabitants. In those countries offering p-PCI services to the majority 
      of their STEMI patients, this population varied between 0.3 and 1.1 million per 
      centre. In-hospital mortality of all consecutive STEMI patients varied between 
      4.2 and 13.5%, for patients treated by TL between 3.5 and 14% and for patients 
      treated by p-PCI between 2.7 and 8%. The time reported from symptom onset to the 
      first medical contact (FMC) varied between 60 and 210 min, FMC-needle time for TL 
      between 30 and 110 min, and FMC-balloon time for p-PCI between 60 and 177 min. 
      CONCLUSION: Most North, West, and Central European countries used p-PCI for the 
      majority of their STEMI patients. The lack of organized p-PCI networks was 
      associated with fewer patients overall receiving some form of reperfusion 
      therapy.
FAU - Widimsky, Petr
AU  - Widimsky P
AD  - Cardiocenter, 3rd Faculty of Medicine, Charles University Prague, Czech Republic. 
      widim@fnkv.cz
FAU - Wijns, William
AU  - Wijns W
FAU - Fajadet, Jean
AU  - Fajadet J
FAU - de Belder, Mark
AU  - de Belder M
FAU - Knot, Jiri
AU  - Knot J
FAU - Aaberge, Lars
AU  - Aaberge L
FAU - Andrikopoulos, George
AU  - Andrikopoulos G
FAU - Baz, Jose Antonio
AU  - Baz JA
FAU - Betriu, Amadeo
AU  - Betriu A
FAU - Claeys, Marc
AU  - Claeys M
FAU - Danchin, Nicholas
AU  - Danchin N
FAU - Djambazov, Slaveyko
AU  - Djambazov S
FAU - Erne, Paul
AU  - Erne P
FAU - Hartikainen, Juha
AU  - Hartikainen J
FAU - Huber, Kurt
AU  - Huber K
FAU - Kala, Petr
AU  - Kala P
FAU - Klinceva, Milka
AU  - Klinceva M
FAU - Kristensen, Steen Dalby
AU  - Kristensen SD
FAU - Ludman, Peter
AU  - Ludman P
FAU - Ferre, Josephina Mauri
AU  - Ferre JM
FAU - Merkely, Bela
AU  - Merkely B
FAU - Milicic, Davor
AU  - Milicic D
FAU - Morais, Joao
AU  - Morais J
FAU - Noc, Marko
AU  - Noc M
FAU - Opolski, Grzegorz
AU  - Opolski G
FAU - Ostojic, Miodrag
AU  - Ostojic M
FAU - Radovanovic, Dragana
AU  - Radovanovic D
FAU - De Servi, Stefano
AU  - De Servi S
FAU - Stenestrand, Ulf
AU  - Stenestrand U
FAU - Studencan, Martin
AU  - Studencan M
FAU - Tubaro, Marco
AU  - Tubaro M
FAU - Vasiljevic, Zorana
AU  - Vasiljevic Z
FAU - Weidinger, Franz
AU  - Weidinger F
FAU - Witkowski, Adam
AU  - Witkowski A
FAU - Zeymer, Uwe
AU  - Zeymer U
CN  - European Association for Percutaneous Cardiovascular Interventions
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20091119
PL  - England
TA  - Eur Heart J
JT  - European heart journal
JID - 8006263
SB  - IM
MH  - Angioplasty, Balloon, Coronary/statistics & numerical data
MH  - Europe/epidemiology
MH  - Health Services Accessibility
MH  - Hospital Mortality
MH  - Hospitalization/statistics & numerical data
MH  - Humans
MH  - Incidence
MH  - Myocardial Infarction/epidemiology/*therapy
MH  - Myocardial Reperfusion/*methods/statistics & numerical data
MH  - Needs Assessment
MH  - Residence Characteristics
MH  - Time Factors
PMC - PMC2854523
EDAT- 2009/11/26 06:00
MHDA- 2011/04/29 06:00
PMCR- 2009/11/19
CRDT- 2009/11/26 06:00
PHST- 2009/11/26 06:00 [entrez]
PHST- 2009/11/26 06:00 [pubmed]
PHST- 2011/04/29 06:00 [medline]
PHST- 2009/11/19 00:00 [pmc-release]
AID - ehp492 [pii]
AID - 10.1093/eurheartj/ehp492 [doi]
PST - ppublish
SO  - Eur Heart J. 2010 Apr;31(8):943-57. doi: 10.1093/eurheartj/ehp492. Epub 2009 Nov 
      19.