BACKGROUND: Guidelines for treatment of patients with myocardial infarction (MI) have been regularly updated. In addition, a new definition for acute MI has been recently established. The aim of our study was to evaluate development of treatment and effects on patient outcome. METHODS: We prospectively collected data from MI patients who were treated in 22 hospitals in Berlin, Germany, during the years 1999 to 2004. In the study we consecutively included 6080 MI patients presenting with (STEMI, n=4314) and without persistent ST-segment elevation (NSTEMI, n=1766). RESULTS: STEMI and NSTEMI patients showed an increase over time in arterial hypertension, smoking, hypercholesterolaemia, history of congestive heart failure, and renal failure. The application of acute percutaneous coronary intervention increased from 15.3% to 62.3% (p<0.001) for NSTEMI and from 24.7% to 71.8% (p<0.001) for STEMI patients. Concomitant therapy with beta-blockers, ACE inhibitors, statins, GP IIb/IIIa, and aspirin increased in parallel in both groups. The decrease in hospital mortality was more pronounced for NSTEMI (13.5% vs. 4.6%, p<0.001) than with STEMI patients (13.0% vs. 9.4%, p=0.005). CONCLUSIONS: Adherence to guidelines has led to a higher level of hospital care for NSTEMI and STEMI patients. Hospital mortality decreased for both groups, with a greater impact on NSTEMI patients.
BACKGROUND: Guidelines for treatment of patients with myocardial infarction (MI) have been regularly updated. In addition, a new definition for acute MI has been recently established. The aim of our study was to evaluate development of treatment and effects on patient outcome. METHODS: We prospectively collected data from MI patients who were treated in 22 hospitals in Berlin, Germany, during the years 1999 to 2004. In the study we consecutively included 6080 MI patients presenting with (STEMI, n=4314) and without persistent ST-segment elevation (NSTEMI, n=1766). RESULTS: STEMI and NSTEMI patients showed an increase over time in arterial hypertension, smoking, hypercholesterolaemia, history of congestive heart failure, and renal failure. The application of acute percutaneous coronary intervention increased from 15.3% to 62.3% (p<0.001) for NSTEMI and from 24.7% to 71.8% (p<0.001) for STEMI patients. Concomitant therapy with beta-blockers, ACE inhibitors, statins, GP IIb/IIIa, and aspirin increased in parallel in both groups. The decrease in hospital mortality was more pronounced for NSTEMI (13.5% vs. 4.6%, p<0.001) than with STEMI patients (13.0% vs. 9.4%, p=0.005). CONCLUSIONS: Adherence to guidelines has led to a higher level of hospital care for NSTEMI and STEMI patients. Hospital mortality decreased for both groups, with a greater impact on NSTEMI patients.
Authors: Birga Maier; Steffen Behrens; Claudia Graf-Bothe; Holger Kuckuck; Jens-Uwe Roehnisch; Ralph G Schoeller; Helmut Schuehlen; Heinz P Theres Journal: Clin Res Cardiol Date: 2010-04-23 Impact factor: 5.460
Authors: Martin Stockburger; Birga Maier; Georg Fröhlich; Wolfgang Rutsch; Steffen Behrens; Ralph Schoeller; Heinz Theres; Stefan Poloczek; Gerd Plock; Helmut Schühlen Journal: Dtsch Arztebl Int Date: 2016-07-25 Impact factor: 5.594
Authors: Birga Maier; Katrin Wagner; Steffen Behrens; Leonhard Bruch; Reinhard Busse; Dagmar Schmidt; Helmut Schühlen; Roland Thieme; Heinz Theres Journal: BMC Health Serv Res Date: 2016-10-21 Impact factor: 2.655