AIMS: The ESC/ACC redefined myocardial infarction as any amount of necrosis caused by ischaemia. The aim of this study was to describe the management and outcomes using 'real-world' data taking the new definition of acute myocardial infarction into account. METHODS AND RESULTS: A total of 2,151 consecutive patients (76.0% men) with a myocardial infarction were enrolled at 56 centres in France. The median delay to presentation was shorter in patients with ST-segment elevation myocardial infarction (STEMI) vs. non-STEMI (NSTEMI) (4 vs. 7 h, P < 0.0001). STEMI patients were more likely to receive fibrinolysis (28.9 vs. 0.7%, P < 0.0001) or undergo PCI (71.0 vs. 51.6%, P < 0.0001) but less likely to have bypass surgery (3.1 vs. 4.9%, P < 0.05). At discharge, patients with STEMI received more aggressive secondary prevention therapies than those with NSTEMI, which was not supported by differences in disease severity. A total of 1878 patients were followed-up for 1 year: 36.7% of STEMI and 41.5% of NSTEMI patients were rehospitalized (P = 0.05); 16% in both groups were revascularized. In-hospital mortality was similar (4.6 vs. 4.3%), and 1-year mortality was 9.0% in STEMI patients and 11.6% in NSTEMI patients (Log-Rank P = 0.09). Independent correlates of in-hospital mortality were untreated dyslipidaemia, advanced age, diabetes, and low blood pressure. The strongest predictors of 1-year mortality were heart failure and age. Similar predictors were found in STEMI and NSTEMI subgroups. CONCLUSIONS: Despite different management, patients with STEMI and NSTEMI have similar prognoses and independent correlates of outcome. These findings support the new definition of myocardial infarction.
AIMS: The ESC/ACC redefined myocardial infarction as any amount of necrosis caused by ischaemia. The aim of this study was to describe the management and outcomes using 'real-world' data taking the new definition of acute myocardial infarction into account. METHODS AND RESULTS: A total of 2,151 consecutive patients (76.0% men) with a myocardial infarction were enrolled at 56 centres in France. The median delay to presentation was shorter in patients with ST-segment elevation myocardial infarction (STEMI) vs. non-STEMI (NSTEMI) (4 vs. 7 h, P < 0.0001). STEMI patients were more likely to receive fibrinolysis (28.9 vs. 0.7%, P < 0.0001) or undergo PCI (71.0 vs. 51.6%, P < 0.0001) but less likely to have bypass surgery (3.1 vs. 4.9%, P < 0.05). At discharge, patients with STEMI received more aggressive secondary prevention therapies than those with NSTEMI, which was not supported by differences in disease severity. A total of 1878 patients were followed-up for 1 year: 36.7% of STEMI and 41.5% of NSTEMI patients were rehospitalized (P = 0.05); 16% in both groups were revascularized. In-hospital mortality was similar (4.6 vs. 4.3%), and 1-year mortality was 9.0% in STEMI patients and 11.6% in NSTEMI patients (Log-Rank P = 0.09). Independent correlates of in-hospital mortality were untreated dyslipidaemia, advanced age, diabetes, and low blood pressure. The strongest predictors of 1-year mortality were heart failure and age. Similar predictors were found in STEMI and NSTEMI subgroups. CONCLUSIONS: Despite different management, patients with STEMI and NSTEMI have similar prognoses and independent correlates of outcome. These findings support the new definition of myocardial infarction.
Authors: Mayra Tisminetzky; David D McManus; Nathaniel Erskine; Jane S Saczynski; Jorge Yarzebski; Edgard Granillo; Joel Gore; Robert J Goldberg Journal: Am J Med Date: 2015-02-03 Impact factor: 4.965
Authors: Robert J Goldberg; Jane S Saczynski; David D McManus; Molly E Waring; Richard McManus; Jeroan Allison; David C Parish; Darleen Lessard; Sharina Person; Joel M Gore; Catarina I Kiefe Journal: Am J Med Date: 2015-05-23 Impact factor: 4.965
Authors: Dharam J Kumbhani; Brian J Wells; A Michael Lincoff; Anil Jain; Susana Arrigain; Changhong Yu; Marlene Goormastic; Stephen G Ellis; Eugene Blackstone; Michael W Kattan Journal: Am J Cardiovasc Dis Date: 2013-02-17
Authors: Erick D McNair; Calvin R Wells; A Mabood Qureshi; Rashpal S Basran; Colin Pearce; Jason Orvold; Jacobus Devilliers; Kailash Prasad Journal: Int J Angiol Date: 2009
Authors: Alka B Patel; Hude Quan; Robert C Welsh; Jessica Deckert-Sookram; Wayne Tymchak; Sunil Sookram; Ian Surdhar; Padma Kaul Journal: CMAJ Open Date: 2015-10-02