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A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis
18:11

A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis

Published on: December 28, 2012

[Treatment of ST-segment elevation acute myocardial infarction in hospitals with and without cardiac catheterization

U Zeymer1, R Hambrecht, H Theres

  • 1Herzzentrum Ludwigshafen, Medizinische Klinik B.

Deutsche Medizinische Wochenschrift (1946)
|September 19, 2013
PubMed

Insights

This study tracked ST-segment elevation myocardial infarction (STEMI) patients in Germany, finding primary percutaneous coronary intervention (PCI) is preferred. In-hospital mortality for STEMI patients was over 7%.

Area of Science:

  • Cardiology
  • Acute Myocardial Infarction Research
  • Health Services Research

Background:

  • The primary goal in treating ST-segment elevation acute myocardial infarction (STEMI) is rapid reperfusion, ideally via primary percutaneous coronary intervention (PCI).
  • The German Myocardial Infarction Registry (DHR) was established to document the acute care and in-hospital outcomes of STEMI patients in Germany.

Purpose of the Study:

  • To document the acute care and in-hospital course of STEMI patients in Germany.
  • To analyze treatment patterns and outcomes based on hospital facilities.

Main Methods:

  • Consecutive enrollment of 6,330 STEMI patients from 243 German hospitals over three months.
  • Centralized data collection via an internet-based questionnaire on demographics, treatments, and complications.
  • Stratification into Group 1 (primary admission to hospitals with cath labs) and Group 2 (primary admission to hospitals without cath labs).

Main Results:

  • 74% of patients were admitted to hospitals with cath labs; 26% to hospitals without.
  • Reperfusion therapy, predominantly primary PCI, was more frequent in Group 1 (93.8%) than Group 2 (87.1%, including transfers).
  • Overall in-hospital mortality was 7.3%, with 7.0% in Group 1 and 8.3% in Group 2.

Conclusions:

  • Approximately 75% of STEMI patients in Germany are initially admitted to hospitals equipped for percutaneous coronary intervention (PCI).
  • Primary PCI is the predominant reperfusion strategy, utilized in about 85% of STEMI cases, whether directly or after transfer.
  • Real-world in-hospital mortality for STEMI exceeds 7%, indicating a gap compared to outcomes in randomized clinical trials.
Abstract

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