PMID- 24062886
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20130924
LR  - 20211021
IS  - 2048-8726 (Print)
IS  - 2048-8734 (Electronic)
IS  - 2048-8726 (Linking)
VI  - 1
IP  - 1
DP  - 2012 Apr
TI  - STEMI mortality in community hospitals versus PCI-capable hospitals: results from 
      a nationwide STEMI network programme.
PG  - 40-7
LID - 10.1177/2048872612441579 [doi]
AB  - AIMS: Reports examining local ST elevation myocardial infarction (STEMI) networks 
      focused mainly on percutaneous coronary intervention (PCI)-related time issues 
      and outcomes. To validate the concept of STEMI networks in a real-world context, 
      more data are needed on management and outcome of an unselected community based 
      STEMI population. METHODS AND RESULTS: The current study evaluated reperfusion 
      strategies and in-hospital mortality in 8500 unselected STEMI patients admitted 
      to 47 community hospitals (n=3053) and 25 PCI-capable hospitals (n=5447) in the 
      context of a nationwide STEMI network programme that started in 2007 in Belgium. 
      The distance between the hub and spoke hospitals ranged from 2.2 to 47 km (median 
      15 km). A propensity score was used to adjust for differences in baseline 
      characteristics. Reperfusion strategy was significantly different with a 
      predominant use of primary PCI (pPCI) in PCI-capable hospitals (93%), compared to 
      a mixed use of pPCI (71%) and thrombolysis (20%) in community hospitals. A 
      door-to-balloon time <120 min was achieved in 83% of community hospitals and in 
      91% of PCI-capable hospitals (p<0.0001). In-hospital mortality was 7.0% in 
      community hospitals versus 6.7% in PCI-capable hospitals with an adjusted odds 
      ratio of 1.1 (95% confidence interval: 0.8-1.4). Between the periods 2007-2008 
      and 2009-2010, the pPCI rate in community hospitals increased from 60% to 80%, 
      whereas the proportion of conservatively managed patients decreased from 11.1% to 
      7.9%. CONCLUSION: In a STEMI network with >70% use of pPCI, in-hospital mortality 
      was comparable between community hospitals and PCI-capable hospitals. 
      Participation in the STEMI network programme was associated with an increased 
      adherence to reperfusion guidelines over time.
FAU - Claeys, Marc J
AU  - Claeys MJ
AD  - University Hospital Antwerp, Edegem, Belgium.
FAU - Sinnaeve, Peter R
AU  - Sinnaeve PR
FAU - Convens, Carl
AU  - Convens C
FAU - Dubois, Philippe
AU  - Dubois P
FAU - Boland, Jean
AU  - Boland J
FAU - Vranckx, Pascal
AU  - Vranckx P
FAU - Gevaert, Sofie
AU  - Gevaert S
FAU - de Meester, Antoine
AU  - de Meester A
FAU - Coussement, Patrick
AU  - Coussement P
FAU - De Raedt, Herbert
AU  - De Raedt H
FAU - Beauloye, Christophe
AU  - Beauloye C
FAU - Renard, Marc
AU  - Renard M
FAU - Vrints, Christiaan
AU  - Vrints C
FAU - Evrard, Patrick
AU  - Evrard P
LA  - eng
PT  - Journal Article
PL  - England
TA  - Eur Heart J Acute Cardiovasc Care
JT  - European heart journal. Acute cardiovascular care
JID - 101591369
PMC - PMC3760556
OTO - NOTNLM
OT  - ST elevation myocardial infarction
OT  - networks
OT  - primary PCI
COIS- None declared.
EDAT- 2012/04/01 00:00
MHDA- 2012/04/01 00:01
PMCR- 2012/04/01
CRDT- 2013/09/25 06:00
PHST- 2011/12/23 00:00 [received]
PHST- 2012/01/30 00:00 [accepted]
PHST- 2013/09/25 06:00 [entrez]
PHST- 2012/04/01 00:00 [pubmed]
PHST- 2012/04/01 00:01 [medline]
PHST- 2012/04/01 00:00 [pmc-release]
AID - 10.1177_2048872612441579 [pii]
AID - 10.1177/2048872612441579 [doi]
PST - ppublish
SO  - Eur Heart J Acute Cardiovasc Care. 2012 Apr;1(1):40-7. doi: 
      10.1177/2048872612441579.