Publication details

Care of patients with ST-elevation myocardial infarction: an international analysis of quality indicators in the acute coronary syndrome STEMI Registry of the EURObservational Research Programme and ACVC and EAPCI Associations of the European Society of Cardiology in 11 462 patients

Authors	LUDMAN Peter ZEYMER Uwe DANCHIN Nicolas KALA Petr LAROCHE Cecile SADEGHI Masoumeh CAPORALE Roberto SHAHEEN Sameh Mohamed LEGUTKO Jacek IAKOBISHVILI Zaza ALHABIB Khalid F MOTOVSKA Zuzana STUDENCAN Martin MIMOSO Jorge BECKER David ALEXOPOULOS Dimitrios KERESESELIDZE Zviad STOJKOVIC Sinisa ZELVEIAN Parounak GODA Artan MIRRAKHIMOV Erkin BAJRAKTARI Gani FARHAN Hasan Ali SERPYTIS Pranas RAUNGAARD Bent MARANDI Toomas MOORE Alice May QUINN Martin KARJALAINEN Pasi Paavo TATU-CHITOIU Gabriel GALE Chris P MAGGIONI Aldo P WEIDINGER Franz
Year of publication	2023
Type	Article in Periodical
Magazine / Source	EUROPEAN HEART JOURNAL-ACUTE CARDIOVASCULAR CARE
MU Faculty or unit	Faculty of Medicine
Citation
Web	https://academic.oup.com/ehjacc/article/12/1/22/6809085?login=true
Doi	http://dx.doi.org/10.1093/ehjacc/zuac143
Keywords	ST-segment elevation myocardial infarction; Primary percutaneous coronary intervention; Quality indicators; Guidelines; Observational studies; Registry; Reperfusion therapy
Description	Aims To use quality indicators to study the management of ST-segment elevation myocardial infarction (STEMI) in different regions. Methods and results Prospective cohort study of STEM I within 24 h of symptom onset (11 462 patients, 196 centres, 26 European Society of Cardiology members, and 3 affiliated countries). The median delay between arrival at a percutaneous cardiovascular intervention (PCI) centre and primary PCI was 40 min (interquartile range 20-74) with 65.8% receiving PCI within guideline recommendation of 60 min. A third of patients (33.2%) required transfer from their initial hospital to one that could perform emergency PCI for whom only 27.2% were treated within the quality indicator recommendation of 120 min. Radial access was used in 56.6% of all primary PCI, but with large geographic variation, from 76.4 to 9.1%. Statins were prescribed at discharge to 98.7% of patients, with little geographic variation. Of patients with a history of heart failure or a documented left ventricular ejection fraction <= 40%, 84.0% were discharged on an angiotensin-converting enzyme inhibitor/angiotensin receptor blocker and 88.7% were discharged on beta-blockers. Conclusion Care for STEMI shows wide geographic variation in the receipt of timely primary PCI, and is in contrast with the more uniform delivery of guideline-recommended pharmacotherapies at time of hospital discharge.