In-hospital prognosis and long-term mortality of STEMI in a reperfusion network. "Head to head" analisys: invasive reperfusion vs optimal medical therapy

Mostra el registre complet Registre parcial de l'ítem

  • dc.contributor.author García-García, Cosmeca
  • dc.contributor.author Ribas Barquet, Núriaca
  • dc.contributor.author Recasens, Lluísca
  • dc.contributor.author Meroño, Oonaca
  • dc.contributor.author Subirana Cachinero, Isaacca
  • dc.contributor.author Fernández, A.ca
  • dc.contributor.author Pérez, Anaca
  • dc.contributor.author Miranda, F.ca
  • dc.contributor.author Tizón-Marcos, Helenaca
  • dc.contributor.author Martí-Almor, Julioca
  • dc.contributor.author Bruguera-Cortada, Jordica
  • dc.contributor.author Elosua Llanos, Robertoca
  • dc.date.accessioned 2018-04-12T07:24:23Z
  • dc.date.available 2018-04-12T07:24:23Z
  • dc.date.issued 2017
  • dc.description.abstract BACKGROUND: ST Segment Elevation Acute myocardial infarction (STEMI) preferred treatment is culprit artery reperfusion with primary percutaneous coronary intervention (PPCI). We ought to analyze the benefit of early reperfusion vs. optimal medical therapy in STEMI before and after the set-up of a regional STEMI network that prioritizes PPCI. METHODS: Between January 2002 and December 2013, 1268 STEMI patients were consecutively admitted in a University Hospital. Patients were classified in two groups: pre-STEMI Network (January 2002-June 2009; n = 670) and post-STEMI network (July 2009-December 2013; n = 598). Vital status was available at 2-year follow-up. RESULTS: The STEMI network increased reperfusion (89.2% vs 64.4%, p < 0.001) mainly using PCI (99.0% vs 43.9%, p < 0.001). In univariate analysis, in-hospital mortality was significantly lower in the post-STEMI network period (2.51% vs. 7.16%, p < 0.001). After multivariate adjustment, including age, sex, comorbidities, severity and reperfusion therapy, a trend to a lower in-hospital mortality was observed (post-Network OR: 0.50, 95% CI:0.16-1.59, p = 0.24); this trend disappeared when optimal medical therapy was included in the model (post-Network OR: 1.14, 95% CI:0.32-4.08, p = 0.840). No differences in 2-year mortality were observed (post-Network HR: 0.83; CI 95%: 0.55-1.25, p = 0.37). CONCLUSION: A STEMI network with PPCI 24/7 improved reperfusion therapy, resulting in an increase on PPCI. Despite in-hospital mortality decreased with a STEMI network, 2-year mortality remained similar in both periods, pre- and post-Network. Optimal medical therapy could be as important as reperfusion therapy in a STEMI reperfusion network.
  • dc.format.mimetype application/pdf
  • dc.identifier.citation García-García C, Ribas N, Recasens LL, Meroño O, Subirana I, Fernández A. et al. In-hospital prognosis and long-term mortality of STEMI in a reperfusion network. "Head to head" analisys: invasive reperfusion vs optimal medical therapy. BMC Cardiovasc Disord. 2017 May 26;17(1):139. DOI: 10.1186/s12872-017-0574-6
  • dc.identifier.doi http://dx.doi.org/10.1186/s12872-017-0574-6
  • dc.identifier.issn 1471-2261
  • dc.identifier.uri http://hdl.handle.net/10230/34343
  • dc.language.iso eng
  • dc.publisher BioMed Centralca
  • dc.rights Copyright © The Author(s). 2017. Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
  • dc.rights.accessRights info:eu-repo/semantics/openAccess
  • dc.rights.uri http://creativecommons.org/licenses/by/4.0/
  • dc.subject.keyword AMI prognosis
  • dc.subject.keyword Long-term mortality
  • dc.subject.keyword Optimal medical therapy
  • dc.subject.keyword Reperfusion network
  • dc.subject.keyword Reperfusion therapy
  • dc.subject.other Infart de miocardi -- Prognosi
  • dc.title In-hospital prognosis and long-term mortality of STEMI in a reperfusion network. "Head to head" analisys: invasive reperfusion vs optimal medical therapyca
  • dc.type info:eu-repo/semantics/article
  • dc.type.version info:eu-repo/semantics/publishedVersion

Col·leccions

Articles (Hospital del Mar Research Institute)