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Boiffard E, Dimet J, Baron O, Billon O, Boivineau C, Charvet M, Doizon T, Federspiel C, Flori M, Georges JL, Haddad G, Lipp D, Nguyen JO, Mouhoub D, Pernollet P, Philippot M, Pouliquen H, Roy N, Trebouet E, Turlotte G, Zeninari B, Orion L. [An independent observatory in Vendée on ST-elevated acute myocardial infarction (the OVISCA Register). A Departmental evaluation of demographic trends, mortality and delays before treatment]. Ann Cardiol Angeiol (Paris) 2019; 68:300-305. [PMID: 31542204 DOI: 10.1016/j.ancard.2019.08.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Accepted: 08/28/2019] [Indexed: 11/17/2022]
Abstract
AIM Mortality from acute myocardial infarction has been falling during the past 30 years. The aim of the study was to evaluate the temporal trends of demographics, mortality rates, and time to treatment in patients admitted for acute ST elevation myocardial infarction (STEMI) in Vendée. PATIENTS AND METHODS From 2008 to 2016, 1994 patients hospitalised in CHD Vendée for STEMI <48hours were included. Two groups were compared, 838 patients admitted between 2008 and 2011 (group 1), and 1156 admitted between 2013 and 2016 (group 2). RESULTS Between the 2 periods, mean age was comparable (63.8 vs. 64.4 years), the gender ratio decreased (from 3.15 to 2.79 ; P=0.25). The mean duration of hospital stay was 0.8 day shorter (P=0.008). Treatment at discharge was optimum in 97.5% patients versus 92% (P<0.001). Left ventricular ejection fraction was comparable (50.6% vs. 50.2%). There was a non-significant trend to a decrease in hospital mortality (from 6.3% to 4.4%; p=0.12), and 6-month mortality (from 6.9% to 5.9%; P=0.51). There was a reduction in the use of emergency call-outs (74.9% to 68.9%; P<0.01), but an increase in direct presentations from 44% to 48.7% (P<0.05). The time before calling was comparable (2.5hours vs. 2.3hours; P=04.7). The "door-to-balloon" time decreased (0.71 vs. 0.55hour; P<0.001). The mean time between pain and angioplasty increased (5.7 vs. 6.8hours; P<0.05). CONCLUSIONS In vendee, from 2011 to 2016, hospital and 6-month mortality of STEMI trend to decrease non-significantly. The door to balloon time decreased, although emergency call-out rates and delays did not. Considerable efforts are still required with respect to patient information and education. Our registry offers an excellent tool to improve practices, the aim being to ensure its integration in the CRAC-France PCI registry.
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Affiliation(s)
- E Boiffard
- Cardiology department, CHD Vendée, Boulevard Moreau, 85000, La Roche-sur-Yon, France.
| | - J Dimet
- Clinical Research Centre, Mont-de-Marsan Hospital, 40000, Mont-de-Marsan, France
| | - O Baron
- Cardiology department, CHD Vendée, Boulevard Moreau, 85000, La Roche-sur-Yon, France
| | - O Billon
- Cardiology department, CHD Vendée, Boulevard Moreau, 85000, La Roche-sur-Yon, France
| | - C Boivineau
- Cardiology department, CHD Vendée, Boulevard Moreau, 85000, La Roche-sur-Yon, France
| | - M Charvet
- Post-emergency medical monitoring, polyclinique de l'Europe, 44600 Saint-Nazaire, France
| | - T Doizon
- General medicine department, CHD Vendée, 85400, Luçon, France
| | - C Federspiel
- Cardiology department, CHD Vendée, Boulevard Moreau, 85000, La Roche-sur-Yon, France
| | - M Flori
- Cardiology department, CHD Vendée, Boulevard Moreau, 85000, La Roche-sur-Yon, France
| | - J-L Georges
- Service de cardiologie centre hospitalier de Versailles, 78150 Le Chesnay, France
| | - G Haddad
- Cardiology department, CHD Vendée, Boulevard Moreau, 85000, La Roche-sur-Yon, France
| | - D Lipp
- Cardiology department, CHD Vendée, Boulevard Moreau, 85000, La Roche-sur-Yon, France
| | - J-O Nguyen
- Cardiology department, CHD Vendée, Boulevard Moreau, 85000, La Roche-sur-Yon, France
| | - D Mouhoub
- Cardiology department, CHD Vendée, Boulevard Moreau, 85000, La Roche-sur-Yon, France
| | - P Pernollet
- Cardiology department, CH Côte-de-Lumière, 85100, Les Sables d'Olonne, France
| | - M Philippot
- Medical Information Service, CHD Vendée, 85000, La Roche-sur-Yon, France
| | - H Pouliquen
- Cardiology department, CHD Vendée, Boulevard Moreau, 85000, La Roche-sur-Yon, France
| | - N Roy
- Cardiology department, CHD Vendée, Boulevard Moreau, 85000, La Roche-sur-Yon, France
| | - E Trebouet
- Emergency Department, CHD Vendée, 85000, La Roche-sur-Yon, France
| | - G Turlotte
- Cardiology department, CHD Vendée, Boulevard Moreau, 85000, La Roche-sur-Yon, France
| | - B Zeninari
- Cardiology department, CHD Vendée, Boulevard Moreau, 85000, La Roche-sur-Yon, France
| | - L Orion
- Cardiology department, CHD Vendée, Boulevard Moreau, 85000, La Roche-sur-Yon, France
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