Trends in Short- and Long-Term ST-Segment-Elevation Myocardial Infarction Prognosis Over 3 Decades : A Mediterranean Population-Based ST-Segment-Elevation Myocardial Infarction Registry
Garcia Garcia, Cosme (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Oliveras, Teresa (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Serra Flores, Jordi (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Vila, Joan (Institut Hospital del Mar d'Investigacions Mèdiques)
Rueda, Ferran (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Cediel, Germán (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Labata, Carlos (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Ferrer Massot, Marc (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Carrillo, Xavier (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Degano, Irene R. (Institut Hospital del Mar d'Investigacions Mèdiques)
De Diego, Oriol (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
El Ouaddi, Nabil (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Montero, Santiago (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Mauri, Josepa (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Elosua, Roberto (Institut Hospital del Mar d'Investigacions Mèdiques)
Lupón, Josep (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Bayés-Genís, Antoni (Universitat Autònoma de Barcelona. Departament de Medicina)

Date:	2020
Abstract:	Coronary artery disease remains a major cause of death despite better outcomes of ST-segment-elevation myocardial infarction (STEMI). We aimed to analyze data from the Ruti-STEMI registry of in-hospital, 28-day, and 1-year events in patients with STEMI over the past 3 decades in Catalonia, Spain, to assess trends in STEMI prognosis. Between February 1989 and December 2017, a total of 7589 patients with STEMI were admitted consecutively. Patients were grouped into 5 periods: 1989 to 1994 (period 1), 1995 to 1999 (period 2), 2000 to 2004 (period 3), 2005 to 2009 (period 4), and 2010 to 2017 (period 5). We used Cox regression to compare 28-day and 1-year STEMI mortality and in-hospital complication trends across these periods. Mean patient age was 61. 6±12. 6 years, and 79. 3% were men. The 28-day all-cause mortality declined from period 1 to period 5 (10. 4% versus 6. 0%; P <0. 001), with a 40% reduction after multivariable adjustment (hazard ratio [HR], 0. 6; 95% CI, 0. 46-0. 80; P <0. 001). One-year all-cause mortality declined from period 1 to period 5 (11. 7% versus 9. 0%; P =0. 001), with a 24% reduction after multivariable adjustment (HR, 0. 76; 95% CI, 0. 60-0. 98; P =0. 036). A significant temporal reduction was observed for in-hospital complications including postinfarct angina (−78%), ventricular tachycardia (−57%), right ventricular dysfunction (−48%), atrioventricular block (−45%), pericarditis (−63%), and free wall rupture (−53%). Primary ventricular fibrillation showed no significant downslope trend. In-hospital STEMI complications and 28-day and 1-year mortality rates have dropped markedly in the past 30 years. Reducing ischemia-driven primary ventricular fibrillation remains a major challenge.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Prognosis ; ST-segment-elevation myocardial infarction ; STEMI complications ; STEMI mortality
Published in:	Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, Vol. 9 (october 2020) , ISSN 2047-9980

DOI: 10.1161/JAHA.120.017159
PMID: 33054490

11 p, 922.2 KB

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Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP)
Articles > Research articles
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