(2023) Care of patients with ST-elevation myocardial infarction: 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. European heart journal. Acute cardiovascular care. pp. 22-37. ISSN 2048-8734 (Electronic) 2048-8726 (Linking)
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Abstract
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.
| Item Type: | Article |
|---|---|
| Keywords: | Humans *ST Elevation Myocardial Infarction/epidemiology/therapy Quality Indicators, Health Care *Percutaneous Coronary Intervention *Acute Coronary Syndrome/therapy Stroke Volume Prospective Studies Ventricular Function, Left *Cardiology Registries Treatment Outcome Guidelines Observational studies Primary percutaneous coronary intervention Quality indicators Registry Reperfusion therapy ST-segment elevation myocardial infarction H.A.F., P.S., M.S., J.M., D.B, D.A., Z.K., S.S., A.M.M., M.Q., and P.P.K. have nothing to disclose. U.Z. reports: Consulting fees from Amgen, personal fees from Amgen payment or honoraria for lectures, presentations, speakers' bureaus, manuscript writing or educational events from Astra Zeneca, Chiesi, Pfizer participation on a Data Safety Monitoring Board or Advisory Board Astra Zeneca, Chiesi, Bayer, Boehriger Ingelhein, outside the submitted work. R.C. reports participation on a Data Safety Monitoring Board or Advisory Board with personal payments from Daiichi Sankyo, Novartis, Boehringer Ingelheim, Lilly, outside the submitted work. Z.I. reports consulting fees with direct payments to author from Pfizer, Astra Zeneca, Bayer payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Novartis, Sanofi, Boehringer Ingelheim outside the submitted work. Z.M. reports consulting fees from Amgen payment or honoraria for lectures, presentations, speakers' bureaus, manuscript writing or educational events from Astra Zeneca, Chiesi, Pfizer participation on a Data Safety Monitoring Board or Advisory Board from Astra Zeneca, Chiesi, Bayer, Boehriger Ingelhein outside the submitted work. T.M. reports receipt of funding from Estonian Research Council PRG435 payment or honoraria for lectures, presentations, speakers' bureaus, manuscript writing, or educational events from AstraZeneca, Eesti outside the submitted work. C.P.G. reports grants or contracts from British Heart Foundation, National Institute for Health Research, Horizon 2020, Abbott Diabetes, Bristol Myers Squibb/Pfizer consulting fees from Amgen, AstraZeneca, Bayer, Bristol Myers Squibb, Boehringer Ingelheim, Chiesi, Daiichi Sankyo, Menarini payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events fromBoehringer Ingelheim, Chiesi, Daiichi Sankyo, Menarini support for attending meetings and/or travel from AstraZeneca, Bayer patents planned, issued, or pending-FIND-AF participation on a Data Safety Monitoring Board or Advisory Board-TARGET CTCA DSMB, DANBLOCK DSMB leadership or fiduciary role in other board, society, committee, or advocacy group, for ESC EuroHeart, NICE IAC, ESC Quality Indicator Committee Chair, outside the submitted work. A.P.M. reports payment or honoraria for lectures, presentations, speakers' bureaus, manuscript writing or educational events-AstraZeneca, Novartis participation in study committees-Bayer, Fresenius, outside the present work. |
| Page Range: | pp. 22-37 |
| Journal or Publication Title: | European heart journal. Acute cardiovascular care |
| Journal Index: | Pubmed |
| Volume: | 12 |
| Number: | 1 |
| Identification Number: | https://doi.org/10.1093/ehjacc/zuac143 |
| ISSN: | 2048-8734 (Electronic) 2048-8726 (Linking) |
| Depositing User: | خانم ناهید ضیائی |
| URI: | http://eprints.mui.ac.ir/id/eprint/27786 |
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