PMID- 24436220
OWN - NLM
STAT- MEDLINE
DCOM- 20140428
LR  - 20220410
IS  - 1468-201X (Electronic)
IS  - 1355-6037 (Linking)
VI  - 100
IP  - 7
DP  - 2014 Apr
TI  - Trends in hospital treatments, including revascularisation, following acute 
      myocardial infarction, 2003-2010: a multilevel and relative survival analysis for 
      the National Institute for Cardiovascular Outcomes Research (NICOR).
PG  - 582-9
LID - 10.1136/heartjnl-2013-304517 [doi]
AB  - OBJECTIVE: To investigate temporal changes in survival after acute myocardial 
      infarction (AMI) by early invasive strategy. METHODS: Accelerated failure time 
      and 6-month relative survival analyses stratified by thrombolysis or primary 
      percutaneous coronary intervention (PPCI) for ST elevation myocardial infarction 
      (STEMI) and coronary angiography for non-STEMI (NSTEMI) encompassing 583 466 
      patients across 247 hospitals in England and Wales over hospital admission 
      periods 2003-2004, 2005-2006, 2007-2008 and 2009-2010. RESULTS: Survival improved 
      significantly for STEMI patients who received reperfusion therapy (time ratio 
      (TR) 1.47, 95% CI 1.22 to 2.78) and was stable for those who did not (TR 1.02, 
      95% CI 0.85 to 1.22). While there were significant improvements in survival for 
      NSTEMI patients who underwent coronary angiography (TR 1.39, 95% CI 1.18 to 
      1.62), there was a significant decline for those who did not (TR 0.70, 95% CI 
      0.65 to 0.75). Patients without reperfusion therapy or coronary angiography had a 
      greater number of comorbidities, but the use of secondary prevention medications 
      was comparable with patients who received reperfusion therapy or coronary 
      angiography. There was a significant hospital-level survival effect, with higher 
      crude 6-month mortality in hospitals in the lowest coronary angiography and PPCI 
      quartiles (angiography Q1: 16.4% vs Q4: 12.8%; PPCI Q1: 15.8% vs Q4: 12.4%). 
      CONCLUSIONS: Survival rates after AMI have improved. Whereas survival estimates 
      for STEMI patients who did not receive reperfusion therapy were stable, they 
      worsened for NSTEMI patients not receiving coronary angiography.
FAU - Gale, C P
AU  - Gale CP
AD  - Division of Epidemiology and Biostatistics, University of Leeds, , Leeds, UK.
FAU - Allan, V
AU  - Allan V
FAU - Cattle, B A
AU  - Cattle BA
FAU - Hall, A S
AU  - Hall AS
FAU - West, R M
AU  - West RM
FAU - Timmis, A
AU  - Timmis A
FAU - Gray, H H
AU  - Gray HH
FAU - Deanfield, J
AU  - Deanfield J
FAU - Fox, K A A
AU  - Fox KA
FAU - Feltbower, R
AU  - Feltbower R
LA  - eng
GR  - MC_PC_13041/MRC_/Medical Research Council/United Kingdom
GR  - MR/K006584/1/MRC_/Medical Research Council/United Kingdom
GR  - NIHR/CS/009/004/DH_/Department of Health/United Kingdom
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20140116
PL  - England
TA  - Heart
JT  - Heart (British Cardiac Society)
JID - 9602087
SB  - IM
MH  - Acute Disease
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Female
MH  - Hospitalization
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/*mortality/*therapy
MH  - Outcome Assessment, Health Care
MH  - Percutaneous Coronary Intervention
MH  - Survival Analysis
MH  - Time Factors
MH  - Young Adult
OTO - NOTNLM
OT  - Hospital treatments
OT  - Myocardial infarction
OT  - Revascularisation
OT  - Survival
OT  - Temporal changes
EDAT- 2014/01/18 06:00
MHDA- 2014/04/29 06:00
CRDT- 2014/01/18 06:00
PHST- 2014/01/18 06:00 [entrez]
PHST- 2014/01/18 06:00 [pubmed]
PHST- 2014/04/29 06:00 [medline]
AID - heartjnl-2013-304517 [pii]
AID - 10.1136/heartjnl-2013-304517 [doi]
PST - ppublish
SO  - Heart. 2014 Apr;100(7):582-9. doi: 10.1136/heartjnl-2013-304517. Epub 2014 Jan 
      16.