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[Reduction in acute myocardial infarction mortality over a five-year period].
Rev Esp Cardiol. 2006 Mar; 59(3):200-8.RE

Abstract

INTRODUCTION AND OBJECTIVES

To assess recent changes in the management of patients with acute myocardial infarction (AMI) and their impact on mortality using data from the PRIAMHO I and II registries (1995 and 2000).

PATIENTS AND METHOD

Of the 168 public hospitals in Spain, 24 and 58 contributed to the 1995 and 2000 PRIAMHO registries, respectively.

RESULTS

Patients in the PRIAMHO II registry (n=6221) were significantly older, more often female, and proportionally more likely to have coronary risk factors or a previous myocardial infarction, or to have undergone revascularization than those in PRIAMHO I (n=5242). Reperfusion therapy was administered more often (46.9% vs 41.9%, P<.001) and earlier (48 min vs 60 min, P<.001). Antiplatelet drugs were given to 96.1% vs 89.1% of patients, beta-blockers to 51.1% vs 30.1%, and ACE inhibitors to 41.6% vs 24.9% (P<.001 for all comparisons). In addition, 28-day mortality was 11.3% and 14.2% (P<.001), respectively, and one-year mortality, 16.4% and 18.5% (P<.001), respectively. The adjusted hazard ratio for mortality at one year in PRIAMHO II compared with PRIAMHO I was 0.78 (95% CI, 0.70-0.86, P<.001; adjusted for age, sex, diabetes, smoking, dyslipemia, hypertension, previous MI and CABG, ST-elevation status and Killip class at admission, and hospital characteristics).

CONCLUSIONS

Even though patients registered in 2000 formed a higher risk group than those registered in 1995, one-year mortality after AMI decreased by 22% over the five-year period. This improvement was due to more frequent and earlier reperfusion therapy and better use of antithrombotics, beta-blockers and ACE inhibitors.

Authors+Show Affiliations

Servicio de Cardiología, Hospital Clínic, Barcelona, España. mheras@clinic.ub.esNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
English Abstract
Journal Article

Language

spa

PubMed ID

16712743

Citation

Heras, Magda, et al. "[Reduction in Acute Myocardial Infarction Mortality Over a Five-year Period]." Revista Espanola De Cardiologia, vol. 59, no. 3, 2006, pp. 200-8.
Heras M, Marrugat J, Arós F, et al. [Reduction in acute myocardial infarction mortality over a five-year period]. Rev Esp Cardiol. 2006;59(3):200-8.
Heras, M., Marrugat, J., Arós, F., Bosch, X., Enero, J., Suárez, M. A., Pabón, P., Ancillo, P., Loma-Osorio, A., Rodríguez, J. J., Subirana, I., & Vila, J. (2006). [Reduction in acute myocardial infarction mortality over a five-year period]. Revista Espanola De Cardiologia, 59(3), 200-8.
Heras M, et al. [Reduction in Acute Myocardial Infarction Mortality Over a Five-year Period]. Rev Esp Cardiol. 2006;59(3):200-8. PubMed PMID: 16712743.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Reduction in acute myocardial infarction mortality over a five-year period]. AU - Heras,Magda, AU - Marrugat,Jaume, AU - Arós,Fernando, AU - Bosch,Xavier, AU - Enero,José, AU - Suárez,Miguel A, AU - Pabón,Pedro, AU - Ancillo,Pablo, AU - Loma-Osorio,Angel, AU - Rodríguez,Juan J, AU - Subirana,Isaac, AU - Vila,Joan, AU - ,, PY - 2006/5/23/pubmed PY - 2006/6/13/medline PY - 2006/5/23/entrez SP - 200 EP - 8 JF - Revista espanola de cardiologia JO - Rev Esp Cardiol VL - 59 IS - 3 N2 - INTRODUCTION AND OBJECTIVES: To assess recent changes in the management of patients with acute myocardial infarction (AMI) and their impact on mortality using data from the PRIAMHO I and II registries (1995 and 2000). PATIENTS AND METHOD: Of the 168 public hospitals in Spain, 24 and 58 contributed to the 1995 and 2000 PRIAMHO registries, respectively. RESULTS: Patients in the PRIAMHO II registry (n=6221) were significantly older, more often female, and proportionally more likely to have coronary risk factors or a previous myocardial infarction, or to have undergone revascularization than those in PRIAMHO I (n=5242). Reperfusion therapy was administered more often (46.9% vs 41.9%, P<.001) and earlier (48 min vs 60 min, P<.001). Antiplatelet drugs were given to 96.1% vs 89.1% of patients, beta-blockers to 51.1% vs 30.1%, and ACE inhibitors to 41.6% vs 24.9% (P<.001 for all comparisons). In addition, 28-day mortality was 11.3% and 14.2% (P<.001), respectively, and one-year mortality, 16.4% and 18.5% (P<.001), respectively. The adjusted hazard ratio for mortality at one year in PRIAMHO II compared with PRIAMHO I was 0.78 (95% CI, 0.70-0.86, P<.001; adjusted for age, sex, diabetes, smoking, dyslipemia, hypertension, previous MI and CABG, ST-elevation status and Killip class at admission, and hospital characteristics). CONCLUSIONS: Even though patients registered in 2000 formed a higher risk group than those registered in 1995, one-year mortality after AMI decreased by 22% over the five-year period. This improvement was due to more frequent and earlier reperfusion therapy and better use of antithrombotics, beta-blockers and ACE inhibitors. SN - 0300-8932 UR - https://www.unboundmedicine.com/medline/citation/16712743/[Reduction_in_acute_myocardial_infarction_mortality_over_a_five_year_period]_ L2 - http://www.revespcardiol.org/en/linksolver/ft/ivp/1579-2242/59/200 DB - PRIME DP - Unbound Medicine ER -