Document Detail


Clinical practice of primary angioplasty for the treatment of acute myocardial infarction in Germany: results from the MITRA and MIR registries.
MedLine Citation:
PMID:  12641017     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The pooled data of two German AMI registries: the Maximal Individual Therapy in Acute Myocardial Infarction (MITRA) study and the Myocardial Infarction Registry (MIR) were analysed in order to 1) describe current clinical practice of primary angioplasty in Germany, 2) compare the results of primary angioplasty with those of thrombolysis in the "real world" and 3) define subgroups of patients profiting probably most from primary angioplasty. Between 1994 and 1998, 20,306 AMI patients were included in the registries. At the 271 participating hospitals angioplasty facilities were available at 18.5%. Thrombolysis was still the most frequently used reperfusion therapy at hospitals without (96%) as well as hospitals with such facilities (55%). Transfer of AMI patients for angiography was performed in 3.6% of AMI patients admitted to hospitals without angioplasty facilities. A total of 9906 lytic eligible AMI patients with a pre-hospital delay of no more than 12 hours were treated with either primary angioplasty (n = 1327) or thrombolysis (n = 8579). Univariate analysis of hospital mortality showed a more favourable course for patients treated with primary angioplasty: 6.4% versus 11.3%, OR = 0.54, 95% CI: 0.43-0.67, p < 0.0001. This was confirmed by logistic regression analysis: multivariate OR = 0.58, 95% CI: 0.44-0.77, p < 0.0001. Primary angioplasty was associated with a lower mortality in all subgroups analysed. There was a significant correlation between mortality and the absolute risk reduction (r = 0.82, p < 0.0001) in the different subgroups, which showed an increasing absolute benefit of primary angioplasty compared to thrombolysis with increasing mortality risk.
Authors:
Ralf Zahn; Rudolf Schiele; Steffen Schneider; Anselm K Gitt; Jochen Senges
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Zeitschrift für Kardiologie     Volume:  91 Suppl 3     ISSN:  0300-5860     ISO Abbreviation:  Z Kardiol     Publication Date:  2002  
Date Detail:
Created Date:  2003-03-18     Completed Date:  2003-03-28     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0360430     Medline TA:  Z Kardiol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  64-71     Citation Subset:  IM    
Affiliation:
Herzzentrum Ludwigshafen, Kardiologie Bremserstrasse 79 67063 Ludwigshafen, Germany. erzahn@aol.com
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MeSH Terms
Descriptor/Qualifier:
Angioplasty, Transluminal, Percutaneous Coronary*
Data Interpretation, Statistical
Female
Germany
Hospital Mortality
Humans
Logistic Models
Male
Middle Aged
Myocardial Infarction / drug therapy,  mortality,  therapy*
Odds Ratio
Prospective Studies
Randomized Controlled Trials as Topic
Registries
Retrospective Studies
Risk
Risk Factors
Survival Analysis
Thrombolytic Therapy*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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