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Edfors R, Jernberg T, Lewinter C, Blöndal M, Eha J, Lõiveke P, Marandi T, Ainla T, Saar A, Veldre G, Ferenci T, Andréka P, Jánosi A, Jortveit J, Halvorsen S. Differences in characteristics, treatments and outcomes in patients with non-ST-elevation myocardial infarction: novel insights from four national European continuous real-world registries. EUROPEAN HEART JOURNAL. QUALITY OF CARE & CLINICAL OUTCOMES 2022; 8:429-436. [PMID: 33605415 DOI: 10.1093/ehjqcco/qcab013] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 01/29/2021] [Accepted: 02/17/2021] [Indexed: 06/12/2023]
Abstract
AIMS To study baseline characteristics, in-hospital managements and mortality of non-ST-elevation myocardial infarction (NSTEMI) patients in different European countries. METHODS AND RESULTS NSTEMI patients enrolled in the national myocardial infarction (MI) registries [EMIR; n = 5817 (Estonia), HUMIR; n = 30 787 (Hungary), NORMI; n = 33 054 (Norway), and SWEDEHEART; n = 49 533 (Sweden)] from 2014 to 2017 were included and presented as aggregated data. The median age at admission ranged from 70 to 75 years. Current smoking status was numerically higher in Norway (24%), Estonia (22%), and Hungary (19%), as compared to Sweden (17%). Patients in Hungary had a high rate of diabetes mellitus (37%) and hypertension (84%). The proportion of performed coronary angiographies (58% vs. 75%) and percutaneous coronary interventions (38% vs. 56%), differed most between Norway and Hungary. Prescription of dual antiplatelet therapy at hospital discharge ranged from 60% (Estonia) to 81% (Hungary). In-hospital death ranged from 3.5% (Sweden) to 9% (Estonia). The crude mortality rate at 1 month was 12% in Norway and 5% in Sweden (5%), whereas the 1-year mortality rates were similar (20-23%) in Hungary, Estonia, and Norway and 15% in Sweden. CONCLUSION Cross-comparisons of four national European MI registries provide important data on differences in risk factors and treatment regiments that may explain some of the observed differences in death rates. A unified European continuous MI registry could be an option to better understand how implementation of guideline-recommended therapy can be used to reduce the burden of cardiovascular disease.
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Affiliation(s)
- Robert Edfors
- Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Morbygardsvagen 5, 1882 57 Stockholm, Sweden
- Bayer AB, Berzelius vag 35, 171 65 Stockholm, Sweden
| | - Tomas Jernberg
- Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Morbygardsvagen 5, 1882 57 Stockholm, Sweden
| | - Christian Lewinter
- Heart and Vascular Theme, Section of Cardiology, Karolinska University Hospital, Eugeniavagen 23, 17165 Stockholm, Sweden
| | - Mai Blöndal
- Heart Clinic, Tartu University Hospital, 8 L. Puusepa Street, 50406 Tartu, Estonia
- Department of Cardiology, University of Tartu, 8 L. Puusepa Street, 50406 Tartu, Estonia
| | - Jaan Eha
- Heart Clinic, Tartu University Hospital, 8 L. Puusepa Street, 50406 Tartu, Estonia
- Department of Cardiology, University of Tartu, 8 L. Puusepa Street, 50406 Tartu, Estonia
| | - Piret Lõiveke
- Department of Cardiology, University of Tartu, 8 L. Puusepa Street, 50406 Tartu, Estonia
- Centre of Cardiology, North Estonia Medical Centre, 19 J. Sütiste Street, 13419 Tallinn, Estonia
| | - Toomas Marandi
- Department of Cardiology, University of Tartu, 8 L. Puusepa Street, 50406 Tartu, Estonia
- Centre of Cardiology, North Estonia Medical Centre, 19 J. Sütiste Street, 13419 Tallinn, Estonia
- Quality Department, North Estonia Medical Centre, 19 J. Sütiste Street, 13419 Tallinn, Estonia
| | - Tiia Ainla
- Department of Cardiology, University of Tartu, 8 L. Puusepa Street, 50406 Tartu, Estonia
- Centre of Cardiology, North Estonia Medical Centre, 19 J. Sütiste Street, 13419 Tallinn, Estonia
| | - Aet Saar
- Centre of Cardiology, North Estonia Medical Centre, 19 J. Sütiste Street, 13419 Tallinn, Estonia
| | - Gudrun Veldre
- Department of Cardiology, University of Tartu, 8 L. Puusepa Street, 50406 Tartu, Estonia
- Estonian Myocardial Infarction Registry, Tartu University Hospital, 8 L. Puusepa Street, 50406 Tartu, Estonia
| | - Tamas Ferenci
- John von Neumann Faculty of Informatics, Institute of Biomatics, Obuda University, Bécsi út 96/b, 1034 Budapest, Hungary
- Department of Statistics, Corvinus University of Budapest, Keleti Károly Street 5-7, 1024 Budapest, Hungary
| | - Péter Andréka
- Gottsegen György National Institute of Cardiology, Hungarian Myocardial Infarction Registry, Haller str 29, 096 Budapest Hungary, Hungary
| | - András Jánosi
- Gottsegen György National Institute of Cardiology, Hungarian Myocardial Infarction Registry, Haller str 29, 096 Budapest Hungary, Hungary
| | - Jarle Jortveit
- Department of Cardiology, Sorlandet Hospital, Box 783, Stoa, 4809 Arendal, Norway
| | - Sigrun Halvorsen
- Department of Cardiology, Oslo University Hospital Ulleval, Oslo and University of Oslo, Kirkeveien 166, 0450 Oslo, Norway
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Breuer T, Jánosi A, Szüts K, Andréka P, Ofner P. [Comparison of the clinical characteristics and hospital treatment of myocardial infarction with and without ST-segment elevation in Hungary. National Registry of Myocardial Infarction]. Orv Hetil 2014; 155:828-32. [PMID: 24836318 DOI: 10.1556/oh.2014.29843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Afew data have been published on the clinical characteristics of different types of myocardial infarction in Hungary. AIM To compare clinical data of patients with ST-segment elevation and non-ST-segment elevation myocardial infarction based on the National Myocardial Infarction Registry database. METHOD Data recorded in the National Myocardial Infarction Registry between January 1, 2010 and June 30, 2012 were included in the analysis. RESULTS Patients treated with non-ST-segment elevation myocardial infarction (n = 5237) were older and had more comorbidities compared to those with ST-segment elevation myocardial infarction (n = 6670). Coronarography and percutaneous coronary intervention were performed more frequently in the latter group. There was no significant difference in in-hospital mortality between the two groups (5.3% and 4.9%). Medication for secondary prevention after myocardial infarction was applied in nearly 90% of the patients in both groups. Dual antiplatelet therapy was more often applied after ST-segment elevation myocardial infarction. CONCLUSIONS The study confirmed important differences in the clinical characteristics and similar hospital prognosis between the two patient groups.
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Affiliation(s)
- Tamás Breuer
- Gottsegen György Országos Kardiológiai Intézet Budapest Haller u. 29. 1096
| | - András Jánosi
- Gottsegen György Országos Kardiológiai Intézet Budapest Haller u. 29. 1096
| | - Krisztina Szüts
- Gottsegen György Országos Kardiológiai Intézet Budapest Haller u. 29. 1096
| | - Péter Andréka
- Gottsegen György Országos Kardiológiai Intézet Budapest Haller u. 29. 1096
| | - Péter Ofner
- Gottsegen György Országos Kardiológiai Intézet Budapest Haller u. 29. 1096
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Abstract
The authors delineate the circumstances of the creation of the National Myocardial Infarction Registry program. This web-based program started in January 1, 2010 as a "pilot" study with the voluntary participation of 12 centres. As a result of professional consensus, the number of participating institutions has continuously increased and, since March 1, 2013, data supply has become obligatory for hospitals treating patients with myocardial infarction. In December, 2013 a new modification of certain health and health insurance related acts such as Act XLVII/1997 regulated the operation of National Myocardial Infraction Registry. At present 65 institutions provide data regularly. The number of patients with myocardial infarction in the database was 24308 in January 1, 2014. The authors summarize the data which accumulated during almost four years of functioning of the National Myocardial Infarction Registry Program. The incidence of myocardial infarction was defined by reviewing the number of pre hospital and hospital cases in five districts of the capital and Szabolcs-Szatmár-Bereg County of Hungary. Reviewing the records patients with ST-elevation and non-ST-elevation myocardial infarction revealed that treatment of 91% of ST-elevation patients occurred in hospitals with cardiac catheterization laboratory, and 82% of patients had primary percutaneous coronary intervention. In-hospital, 30-day and 1-year mortality were defined for patients treated for both types of myocardial infarction. Based on national and international experience, the authors emphasize that professional characteristics of patient care can only be assessed using specific patient registries and these data are essential in the development of an efficient health-care system.
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Affiliation(s)
- András Jánosi
- Gottsegen György Országos Kardiológiai Intézet Budapest
| | - Péter Ofner
- Gottsegen György Országos Kardiológiai Intézet Budapest
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