TY - JOUR
T1 - Care of patients with ST-elevation myocardial infarction
T2 - an international analysis of quality indicators in the acute coronary syndrome STEMI Registry of the EURObservational Research Programme and ACVC and EAPCI Associations of the European Society of Cardiology in 11 462 patients
AU - ACVC-EAPCI EORP ACS STEMI investigators group of the ESC
AU - Ludman, Peter
AU - Zeymer, Uwe
AU - Danchin, Nicolas
AU - Kala, Petr
AU - Laroche, Cécile
AU - Sadeghi, Masoumeh
AU - Caporale, Roberto
AU - Shaheen, Sameh Mohamed
AU - Legutko, Jacek
AU - Iakobishvili, Zaza
AU - Alhabib, Khalid F
AU - Motovska, Zuzana
AU - Studencan, Martin
AU - Mimoso, Jorge
AU - Becker, David
AU - Alexopoulos, Dimitrios
AU - Kereseselidze, Zviad
AU - Stojkovic, Sinisa
AU - Zelveian, Parounak
AU - Goda, Artan
AU - Mirrakhimov, Erkin
AU - Bajraktari, Gani
AU - Farhan, Hasan Ali
AU - Šerpytis, Pranas
AU - Raungaard, Bent
AU - Marandi, Toomas
AU - Moore, Alice May
AU - Quinn, Martin
AU - Karjalainen, Pasi Paavo
AU - Tatu-Chitoiu, Gabriel
AU - Gale, Chris P
AU - Maggioni, Aldo P
AU - Weidinger, Franz
AU - Neunteufl, Thomas
AU - Neuhold, Ulrike
AU - Mihalcz, Attila
N1 - Publisher Copyright:
© The Author(s) 2022. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved.
PY - 2023/1/27
Y1 - 2023/1/27
N2 - AIMS: To use quality indicators to study the management of ST-segment elevation myocardial infarction (STEMI) in different regions.METHODS AND RESULTS: Prospective cohort study of STEMI within 24 h of symptom onset (11 462 patients, 196 centres, 26 European Society of Cardiology members, and 3 affiliated countries). The median delay between arrival at a percutaneous cardiovascular intervention (PCI) centre and primary PCI was 40 min (interquartile range 20-74) with 65.8% receiving PCI within guideline recommendation of 60 min. A third of patients (33.2%) required transfer from their initial hospital to one that could perform emergency PCI for whom only 27.2% were treated within the quality indicator recommendation of 120 min. Radial access was used in 56.6% of all primary PCI, but with large geographic variation, from 76.4 to 9.1%. Statins were prescribed at discharge to 98.7% of patients, with little geographic variation. Of patients with a history of heart failure or a documented left ventricular ejection fraction ≤40%, 84.0% were discharged on an angiotensin-converting enzyme inhibitor/angiotensin receptor blocker and 88.7% were discharged on beta-blockers.CONCLUSION: Care for STEMI shows wide geographic variation in the receipt of timely primary PCI, and is in contrast with the more uniform delivery of guideline-recommended pharmacotherapies at time of hospital discharge.
AB - AIMS: To use quality indicators to study the management of ST-segment elevation myocardial infarction (STEMI) in different regions.METHODS AND RESULTS: Prospective cohort study of STEMI within 24 h of symptom onset (11 462 patients, 196 centres, 26 European Society of Cardiology members, and 3 affiliated countries). The median delay between arrival at a percutaneous cardiovascular intervention (PCI) centre and primary PCI was 40 min (interquartile range 20-74) with 65.8% receiving PCI within guideline recommendation of 60 min. A third of patients (33.2%) required transfer from their initial hospital to one that could perform emergency PCI for whom only 27.2% were treated within the quality indicator recommendation of 120 min. Radial access was used in 56.6% of all primary PCI, but with large geographic variation, from 76.4 to 9.1%. Statins were prescribed at discharge to 98.7% of patients, with little geographic variation. Of patients with a history of heart failure or a documented left ventricular ejection fraction ≤40%, 84.0% were discharged on an angiotensin-converting enzyme inhibitor/angiotensin receptor blocker and 88.7% were discharged on beta-blockers.CONCLUSION: Care for STEMI shows wide geographic variation in the receipt of timely primary PCI, and is in contrast with the more uniform delivery of guideline-recommended pharmacotherapies at time of hospital discharge.
KW - Humans
KW - ST Elevation Myocardial Infarction/epidemiology
KW - Quality Indicators, Health Care
KW - Percutaneous Coronary Intervention
KW - Acute Coronary Syndrome/therapy
KW - Stroke Volume
KW - Prospective Studies
KW - Ventricular Function, Left
KW - Cardiology
KW - Registries
KW - Treatment Outcome
UR - http://www.scopus.com/inward/record.url?scp=85164548737&partnerID=8YFLogxK
U2 - 10.1093/ehjacc/zuac143
DO - 10.1093/ehjacc/zuac143
M3 - Journal article
C2 - 36346109
SN - 2048-8726
VL - 12
SP - 22
EP - 37
JO - European Heart Journal: Acute Cardiovascular Care
JF - European Heart Journal: Acute Cardiovascular Care
IS - 1
ER -