Trends in short- and long-term ST-segment-elevation myocardial infarction prognosis over 3 decades: a mediterranean population-based ST-segment-elevation myocardial infarction registry

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  • dc.contributor.author García-García, Cosme
  • dc.contributor.author Oliveras, Teresa
  • dc.contributor.author Serra, Jordi
  • dc.contributor.author Vila, Joan
  • dc.contributor.author Rueda, Ferran
  • dc.contributor.author Cediel, German
  • dc.contributor.author Labata, Carlos
  • dc.contributor.author Ferrer, Marc
  • dc.contributor.author Carrillo, Xavier
  • dc.contributor.author Dégano, Irene R.
  • dc.contributor.author de Diego, Oriol
  • dc.contributor.author El Ouaddi, Nabil
  • dc.contributor.author Montero, Santiago
  • dc.contributor.author Mauri, Josepa
  • dc.contributor.author Elosua Llanos, Roberto
  • dc.contributor.author Lupón, Josep
  • dc.contributor.author Bayes-Genis, Antoni
  • dc.contributor.author Ruti‐STEMI Investigators
  • dc.date.accessioned 2021-11-11T07:54:26Z
  • dc.date.available 2021-11-11T07:54:26Z
  • dc.date.issued 2020
  • dc.description.abstract Background Coronary artery disease remains a major cause of death despite better outcomes of ST-segment-elevation myocardial infarction (STEMI). We aimed to analyze data from the Ruti-STEMI registry of in-hospital, 28-day, and 1-year events in patients with STEMI over the past 3 decades in Catalonia, Spain, to assess trends in STEMI prognosis. Methods and Results Between February 1989 and December 2017, a total of 7589 patients with STEMI were admitted consecutively. Patients were grouped into 5 periods: 1989 to 1994 (period 1), 1995 to 1999 (period 2), 2000 to 2004 (period 3), 2005 to 2009 (period 4), and 2010 to 2017 (period 5). We used Cox regression to compare 28-day and 1-year STEMI mortality and in-hospital complication trends across these periods. Mean patient age was 61.6±12.6 years, and 79.3% were men. The 28-day all-cause mortality declined from period 1 to period 5 (10.4% versus 6.0%; P<0.001), with a 40% reduction after multivariable adjustment (hazard ratio [HR], 0.6; 95% CI, 0.46-0.80; P<0.001). One-year all-cause mortality declined from period 1 to period 5 (11.7% versus 9.0%; P=0.001), with a 24% reduction after multivariable adjustment (HR, 0.76; 95% CI, 0.60-0.98; P=0.036). A significant temporal reduction was observed for in-hospital complications including postinfarct angina (-78%), ventricular tachycardia (-57%), right ventricular dysfunction (-48%), atrioventricular block (-45%), pericarditis (-63%), and free wall rupture (-53%). Primary ventricular fibrillation showed no significant downslope trend. Conclusions In-hospital STEMI complications and 28-day and 1-year mortality rates have dropped markedly in the past 30 years. Reducing ischemia-driven primary ventricular fibrillation remains a major challenge.
  • dc.format.mimetype application/pdf
  • dc.identifier.citation García-García C, Oliveras T, Serra J, Vila J, Rueda F, Cediel G, et al. Trends in short- and long-term ST-segment-elevation myocardial infarction prognosis over 3 decades: a mediterranean population-based ST-segment-elevation myocardial infarction registry. J Am Heart Assoc. 2020 Oct 20; 9(20):e017159. DOI: 10.1161/JAHA.120.017159
  • dc.identifier.doi http://dx.doi.org/10.1161/JAHA.120.017159
  • dc.identifier.issn 2047-9980
  • dc.identifier.uri http://hdl.handle.net/10230/48951
  • dc.language.iso eng
  • dc.publisher Wiley
  • dc.rights Copyright © 2020 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley. This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
  • dc.rights.accessRights info:eu-repo/semantics/openAccess
  • dc.rights.uri http://creativecommons.org/licenses/by-nc-nd/4.0/
  • dc.subject.keyword STEMI complications
  • dc.subject.keyword STEMI mortality
  • dc.subject.keyword ST‐segment–elevation myocardial infarction
  • dc.subject.keyword Prognosis
  • dc.title Trends in short- and long-term ST-segment-elevation myocardial infarction prognosis over 3 decades: a mediterranean population-based ST-segment-elevation myocardial infarction registry
  • dc.type info:eu-repo/semantics/article
  • dc.type.version info:eu-repo/semantics/publishedVersion

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