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Titolo:
Acute myocardial infarction occurring in versus out of the hospital: Patient characteristics and clinical outcome
Autore:
Zahn, R; Schiele, R; Seidl, K; Kapp, T; Glunz, HG; Jagodzinski, E; Voigtlander, T; Gottwik, M; Berg, G; Thomas, H; Senges, J;
Indirizzi:
Herzzentrum Ludwigshafen, Dept Cardiol, D-67063 Ludwigshafen, Germany Herzzentrum Ludwigshafen Ludwigshafen Germany D-67063 wigshafen, Germany Cincentius Krankenhaus Speyer, Speyer, Germany Cincentius Krankenhaus Speyer Speyer Germany us Speyer, Speyer, Germany Westpfalz Klinikum Kaiserslautern, Kaiserslautern, Germany Westpfalz Klinikum Kaiserslautern Kaiserslautern Germany utern, Germany Marienkrankenhaus Ludwigshafen, Ludwigshafen, Germany Marienkrankenhaus Ludwigshafen Ludwigshafen Germany dwigshafen, Germany Univ Mainz, D-6500 Mainz, Germany Univ Mainz Mainz Germany D-6500Univ Mainz, D-6500 Mainz, Germany Klinikum Nurnberg, Nurnberg, Germany Klinikum Nurnberg Nurnberg GermanyKlinikum Nurnberg, Nurnberg, Germany Univ Klinikum Homburg, Homburg, Germany Univ Klinikum Homburg Homburg Germany linikum Homburg, Homburg, Germany Evangel Krankenhaus, Bad Durkheim, Germany Evangel Krankenhaus Bad Durkheim Germany kenhaus, Bad Durkheim, Germany
Titolo Testata:
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
fascicolo: 7, volume: 35, anno: 2000,
pagine: 1820 - 1826
SICI:
0735-1097(200006)35:7<1820:AMIOIV>2.0.ZU;2-#
Fonte:
ISI
Lingua:
ENG
Soggetto:
PRIMARY CORONARY ANGIOPLASTY; THROMBOLYTIC THERAPY; REPERFUSION THERAPY; RISK; CONTRAINDICATIONS; TRANSPORT; REGISTRY; FATALITY; EVENTS;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
23
Recensione:
Indirizzi per estratti:
Indirizzo: Zahn, R Herzzentrum Ludwigshafen, Dept Cardiol, Bremserstr 79, D-67063 Ludwigshafen, Germany Herzzentrum Ludwigshafen Bremserstr 79 Ludwigshafen Germany D-67063
Citazione:
R. Zahn et al., "Acute myocardial infarction occurring in versus out of the hospital: Patient characteristics and clinical outcome", J AM COL C, 35(7), 2000, pp. 1820-1826

Abstract

OBJECTIVES We describe the baseline characteristics and clinical course ofpatients who had an acute myocardial infarction (AMI) during their hospital stay. BACKGROUND In comparison with patients who had an AMI outside of the hospital (prehospital AMI), the data on patients who had an AMI in the hospital are poorly described. METHODS Patients with an in-hospital AMI were prospectively registered in the Southwest German Maximal Individual TheRapy in Acute myocardial infarction (MITRA) study and compared with patients with prehospital AMI. RESULTS Of 5,888 patients with AMI, 403 patients (6.8%) had an in-hospitalAMI. These patients were older, more often male and sicker as compared with the patients with a prehospital AMI. They also showed a higher prevalenceof concomitant diseases, such as arterial hypertension, diabetes mellitus,renal insufficiency and contraindications for thrombolysis. There was no significant difference regarding the use of reperfusion therapy, either thrombolysis (in-hospital AMI 44.2% vs. prehospital AMI 49.1%; odds ratio [OR] 0.86, 95% confidence interval [CI] 0.70 to 1.05) or primary angioplasty (9.9% vs. 8.2%; OR 1.23, 95% CI 0.88 to 1.73), or a combination of both, between the two groups. The interval from symptom onset to the start of treatment in patients receiving reperfusion therapy was 55 min for patients with anin-hospital AMI versus 180 min for patients with a prehospital AMI (p = 0.001). In-hospital death occurred in 110 (27.3%) of 403 patients with an in-hospital versus 762 (13.9%) of 5,485 patients with a prehospital AMI (OR 2.33, 95% CI 1.85 to 2.44). This was confirmed by logistic regression analysis after adjusting for other confounding variables (OR 1.67, 95% CI 1.23 to 2.24). CONCLUSIONS In-hospital AMI occurred in 6.8% of patients. Time to intervention was shorter; however, the use of reperfusion therapy for in-hospital AMI was not different from that for prehospital AMI. In particular, primary angioplasty seems to be underused in these patients. This, as well as the selection of patients, may result in the high hospital mortality rate of 27.3%. (J Am Coll Cardiol 2000;35:1820-6) (C) 2000 by the American College of Cardiology.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 09/04/20 alle ore 08:57:53