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Titolo:
THE 60 MINUTES MYOCARDIAL-INFARCTION PROJECT - TREATMENT AND CLINICALOUTCOME OF PATIENTS WITH ACUTE MYOCARDIAL-INFARCTION IN GERMANY
Autore:
RUSTIGE J; SCHIELE R; BURCZYK U; KOCH A; GOTTWIK M; NEUHAUS KL; TEBBE U; UEBIS R; SENGES J;
Indirizzi:
HERZZENTRUM LUDWIGSHAFEN,DEPT CARDIOL,BREMSERSTR 79 D-67063 LUDWIGSHAFEN GERMANY ZENTRUM METHOD BETREUUNG THERAPIESTUDIEN HEIDELBERG GERMANY KLINIKUM ASCHAFFENBURG ASCHAFFENBURG GERMANY STADT KLINIKEN KASSEL KASSEL GERMANY KLINIKUM NURNBERG NURNBERG GERMANY
Titolo Testata:
European heart journal
fascicolo: 9, volume: 18, anno: 1997,
pagine: 1438 - 1446
SICI:
0195-668X(1997)18:9<1438:T6MMP->2.0.ZU;2-R
Fonte:
ISI
Lingua:
ENG
Soggetto:
THROMBOLYTIC THERAPY; IMMEDIATE ANGIOPLASTY; CORONARY ANGIOPLASTY; NATIONAL-REGISTRY; TIME DELAYS; TRIALS; TRENDS; DIAGNOSIS; MORTALITY; IMPACT;
Keywords:
ACUTE MYOCARDIAL INFARCTION; REGISTRY; THROMBOLYSIS; PREHOSPITAL DELAY;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
41
Recensione:
Indirizzi per estratti:
Citazione:
J. Rustige et al., "THE 60 MINUTES MYOCARDIAL-INFARCTION PROJECT - TREATMENT AND CLINICALOUTCOME OF PATIENTS WITH ACUTE MYOCARDIAL-INFARCTION IN GERMANY", European heart journal, 18(9), 1997, pp. 1438-1446

Abstract

Aims To describe patient characteristics, pre-hospital delay, treatment, complications and outcome in patients with acute myocardial infarction admitted to hospitals in Germany. Methods and results The study was of prospective observational multicentre design. Those involved were consecutive patients with acute Q-wave myocardial infarction admitted within 96 h of onset of symptoms to 136 German hospitals between July 1992 and September 1994 (n = 14980, median age 66 (quartiles 57, 74)years, 68% male, 48% anterior wall infarction). Median pre-hospital delay was 170 (90, 475) min, with 17% arriving within the first hour and 61% within 4 h of onset of symptoms. The following patient groups had a short pre-hospital delay: males, those aged less than 65 years, those admitted at night or the weekend. those with a previous myocardialinfarction, those in need of cardiopulmonary resuscitation, and thosewith a diagnostic first EGG. The first ECG was diagnostic in 67.6% ofcases. Reperfusion therapy was used in 53%, with thrombolytic therapyin 51.6%. Median time from admission to initiation of treatment was 30 (20, 55) min. Respective rates of treatment with aspirin, nitrates, and beta-blockers were 81%, 83% and 16%. Major complications were cerebral bleeding (0.4%), bleeding requiring transfusions (0.9%), left ventricular rupture (0.6%) and anaphylactic shock (0.1%). Median hospitalstay was 20 (13, 26) days. In-hospital death rate was 17.2%. Increased hospital mortality was observed with female gender, an unknown or long pre-hospital delay, a diagnostic first EGG, anterior wall infarction, trauma. or major operation within the last 14 days, renal insufficiency and malignoma. Conclusions 'Real-life' hospital mortality is muchhigher than previously reported in clinical trials. To reduce hospital mortality, the efficacy of thrombolysis should be increased by shortening the pre-hospital delay, and the use of concomitant therapy, especially beta-blockers, should be increased.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 30/03/20 alle ore 19:47:01