[STEMI network Essen-in-hospital results]

Area of Science:

• Cardiology
• Public Health
• Health Services Research

Background:

• The "Herzinfarktverbund Essen" network was established in 2004 to integrate guideline-recommended therapy for ST-elevation myocardial infarction (STEMI) into routine clinical practice.
• The network focused on primary percutaneous coronary intervention (PCI) as the primary reperfusion method, early medication prescription, and optimized patient care pathways.

Purpose of the Study:

• To evaluate the effectiveness of a structured, urban-wide network for STEMI care in improving patient outcomes.
• To assess the impact of guideline-conformal STEMI management on in-hospital mortality, medication adherence, and rehabilitation referral rates.

Main Methods:

• The study analyzed data from the first year of the "Herzinfarktverbund Essen" network, involving 489 patients treated in five high-volume PCI centers.
• Primary PCI was performed in 90.8% of STEMI cases.

Main Results:

• In-hospital mortality was 7.6%, which was lower compared to historical STEMI registries with less frequent PCI.
• Left ventricular ejection fraction (EF) was the strongest predictor of mortality; EF ≤30% correlated with a 27-fold increased risk.
• Guideline-recommended medications were prescribed to 75% of patients, with 71% receiving a five-drug regimen including ACE inhibitors.
• 72% of patients were referred to rehabilitation therapy.

Conclusions:

• The "Herzinfarktverbund Essen" network successfully demonstrated that implementing guideline-conformal STEMI therapy in an urban setting can reduce in-hospital mortality.
• The network also led to increased prescription rates of recommended medications and improved patient adherence to outpatient therapies.