PMID- 20805111
OWN - NLM
STAT- MEDLINE
DCOM- 20111123
LR  - 20201216
IS  - 1522-9645 (Electronic)
IS  - 0195-668X (Linking)
VI  - 31
IP  - 21
DP  - 2010 Nov
TI  - Reperfusion strategy in Europe: temporal trends in performance measures for 
      reperfusion therapy in ST-elevation myocardial infarction.
PG  - 2614-24
LID - 10.1093/eurheartj/ehq305 [doi]
AB  - AIMS: The rate and type of reperfusion, as well as time delays to reperfusion are 
      directly associated with mortality and are established as performance measures 
      (PMs) in the treatment of ST elevation myocardial infarction (STEMI). To date, 
      little information exists about PMs for reperfusion in clinical practice in 
      Europe and their temporal changes. METHODS AND RESULTS: Using the Euro Heart 
      Survey ACS-III data set (2 years of inclusions between 2006 and 2008, 138 centres 
      in 21 countries), we selected patients with STEMI eligible for reperfusion 
      therapy. Recorded variables corresponded to the CARDS data set. The rate and type 
      of reperfusion, as well as door to needle and door to artery times were assessed 
      and compared between periods. Timely reperfusion was defined as a door to needle 
      time < 30 min, or a door to artery time < 90 min. We assessed changes in PMs for 
      reperfusion over the 2 years of recruitment. Among 19 205 patients included in 
      the registry, 7655 had STEMI, and 6481 were admitted within the first 12 h and 
      eligible for reperfusion. The rate of patients who underwent reperfusion 
      increased from 77.2 to 81.3%, with an increase in the use of primary percutaneous 
      coronary intervention (P-PCI). The door to needle and door to artery times 
      decreased significantly during the study period, from 20 to 15 min (P = 0.0011) 
      and from 60 to 45 min (P < 0.0001) respectively. As a result, the number of 
      eligible patients receiving reperfusion therapy in a timely manner increased from 
      53.1 to 63.5% (P < 0.0001). In parallel, over the 2-year period, in-hospital 
      mortality decreased from 8.1 to 6.6% (P = 0.047). CONCLUSION: In centres 
      participating in the Euro Heart Survey ACS III, PMs for reperfusion in STEMI 
      improved significantly between 2006 and 2008, with greater use of PCI. Similarly, 
      the rate of patients reperfused in a timely manner also increased, with a 
      significant reduction in door to needle and door to artery times.
FAU - Schiele, Francois
AU  - Schiele F
AD  - University Hospital Jean Minjoz, Boulevard Fleming, 25000 Besancon, France. 
      francois.schiele@univ-fcomte.fr
FAU - Hochadel, Matthias
AU  - Hochadel M
FAU - Tubaro, Marco
AU  - Tubaro M
FAU - Meneveau, Nicolas
AU  - Meneveau N
FAU - Wojakowski, Wojtek
AU  - Wojakowski W
FAU - Gierlotka, Marek
AU  - Gierlotka M
FAU - Polonski, Lech
AU  - Polonski L
FAU - Bassand, Jean-Pierre
AU  - Bassand JP
FAU - Fox, Keith A A
AU  - Fox KA
FAU - Gitt, Anselm K
AU  - Gitt AK
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, Non-U.S. Gov't
DEP - 20100830
PL  - England
TA  - Eur Heart J
JT  - European heart journal
JID - 8006263
RN  - 0 (Fibrinolytic Agents)
SB  - IM
CIN - Eur Heart J. 2010 Nov;31(21):2580-2. PMID: 20880951
MH  - Angioplasty, Balloon, Coronary/methods/statistics & numerical data
MH  - Europe
MH  - Female
MH  - Fibrinolytic Agents/therapeutic use
MH  - Hemorrhage/etiology
MH  - Hospitalization/statistics & numerical data
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/*therapy
MH  - Myocardial Reperfusion/*methods/statistics & numerical data
MH  - Recurrence
MH  - Stroke/etiology
MH  - Time Factors
MH  - Treatment Outcome
EDAT- 2010/09/02 06:00
MHDA- 2011/12/13 00:00
CRDT- 2010/09/01 06:00
PHST- 2010/09/01 06:00 [entrez]
PHST- 2010/09/02 06:00 [pubmed]
PHST- 2011/12/13 00:00 [medline]
AID - ehq305 [pii]
AID - 10.1093/eurheartj/ehq305 [doi]
PST - ppublish
SO  - Eur Heart J. 2010 Nov;31(21):2614-24. doi: 10.1093/eurheartj/ehq305. Epub 2010 
      Aug 30.