OBJECTIVE: To investigate temporal changes in survival after acute myocardial infarction (AMI) by early invasive strategy. METHODS: Accelerated failure time and 6-month relative survival analyses stratified by thrombolysis or primary percutaneous coronary intervention (PPCI) for ST elevation myocardial infarction (STEMI) and coronary angiography for non-STEMI (NSTEMI) encompassing 583 466 patients across 247 hospitals in England and Wales over hospital admission periods 2003-2004, 2005-2006, 2007-2008 and 2009-2010. RESULTS: Survival improved significantly for STEMI patients who received reperfusion therapy (time ratio (TR) 1.47, 95% CI 1.22 to 2.78) and was stable for those who did not (TR 1.02, 95% CI 0.85 to 1.22). While there were significant improvements in survival for NSTEMI patients who underwent coronary angiography (TR 1.39, 95% CI 1.18 to 1.62), there was a significant decline for those who did not (TR 0.70, 95% CI 0.65 to 0.75). Patients without reperfusion therapy or coronary angiography had a greater number of comorbidities, but the use of secondary prevention medications was comparable with patients who received reperfusion therapy or coronary angiography. There was a significant hospital-level survival effect, with higher crude 6-month mortality in hospitals in the lowest coronary angiography and PPCI quartiles (angiography Q1: 16.4% vs Q4: 12.8%; PPCI Q1: 15.8% vs Q4: 12.4%). CONCLUSIONS: Survival rates after AMI have improved. Whereas survival estimates for STEMI patients who did not receive reperfusion therapy were stable, they worsened for NSTEMI patients not receiving coronary angiography.
OBJECTIVE: To investigate temporal changes in survival after acute myocardial infarction (AMI) by early invasive strategy. METHODS: Accelerated failure time and 6-month relative survival analyses stratified by thrombolysis or primary percutaneous coronary intervention (PPCI) for ST elevation myocardial infarction (STEMI) and coronary angiography for non-STEMI (NSTEMI) encompassing 583 466 patients across 247 hospitals in England and Wales over hospital admission periods 2003-2004, 2005-2006, 2007-2008 and 2009-2010. RESULTS: Survival improved significantly for STEMI patients who received reperfusion therapy (time ratio (TR) 1.47, 95% CI 1.22 to 2.78) and was stable for those who did not (TR 1.02, 95% CI 0.85 to 1.22). While there were significant improvements in survival for NSTEMI patients who underwent coronary angiography (TR 1.39, 95% CI 1.18 to 1.62), there was a significant decline for those who did not (TR 0.70, 95% CI 0.65 to 0.75). Patients without reperfusion therapy or coronary angiography had a greater number of comorbidities, but the use of secondary prevention medications was comparable with patients who received reperfusion therapy or coronary angiography. There was a significant hospital-level survival effect, with higher crude 6-month mortality in hospitals in the lowest coronary angiography and PPCI quartiles (angiography Q1: 16.4% vs Q4: 12.8%; PPCI Q1: 15.8% vs Q4: 12.4%). CONCLUSIONS: Survival rates after AMI have improved. Whereas survival estimates for STEMI patients who did not receive reperfusion therapy were stable, they worsened for NSTEMI patients not receiving coronary angiography.
Authors: Adam M Garber; Robert J Mentz; Hussein R Al-Khalidi; Linda K Shaw; Mona Fiuzat; Christopher M O'Connor; Eric J Velazquez Journal: J Thromb Thrombolysis Date: 2016-04 Impact factor: 2.300
Authors: Tatendashe Bernadette Dondo; Marlous Hall; Theresa Munyombwe; Chris Wilkinson; Mohammad E Yadegarfar; Adam Timmis; Philip D Batin; Tomas Jernberg; Keith Aa Fox; Chris P Gale Journal: Heart Date: 2019-11-15 Impact factor: 5.994
Authors: Simon Walker; Miqdad Asaria; Andrea Manca; Stephen Palmer; Chris P Gale; Anoop Dinesh Shah; Keith R Abrams; Michael Crowther; Adam Timmis; Harry Hemingway; Mark Sculpher Journal: Eur Heart J Qual Care Clin Outcomes Date: 2016-01-20
Authors: Krystian Wita; Andrzej Kułach; Marcin Wita; Maciej T Wybraniec; Katarzyna Wilkosz; Mateusz Polak; Monika Matla; Łukasz Maciejewski; Joanna Fluder; Barbara Kalańska-Łukasik; Tomasz Skowerski; Szymon Gomułka; Krzysztof Szydło Journal: Arch Med Sci Date: 2019-06-06 Impact factor: 3.318
Authors: Mathijs C Bodde; Maaike P J Hermans; Arnoud van der Laarse; Bart Mertens; Fred P H T M Romijn; Martin J Schalij; Christa M Cobbaert; J Wouter Jukema Journal: Cardiol Ther Date: 2019-01-30