changes in clinical profile, treatment, and mortality in patients hospitalised for acute myocardial infarction between 1985 and 2008变化的临床资料、治疗和死亡率之间的急性心肌梗死患者住院1985年和2008年.pdfVIP

Changes in Clinical Profile, Treatment, and Mortality in Patients Hospitalised for Acute Myocardial Infarction between 1985 and 2008 Sjoerd T. Nauta, Jaap W. Deckers*, Martijn Akkerhuis, Mattie Lenzen, Maarten L. Simoons, Ron T. van Domburg Department of Cardiology, Erasmus Medical Center, Rotterdam, The Netherlands Abstract Objectives: To quantify the impact of the implementation of treatment modalities into clinical practice since 1985, on outcome of patients with ST-segment elevation myocardial infarction (STEMI) or non-ST-segment elevation myocardial infarction (NSTEMI). Methods: All consecutive patients admitted for STEMI or NSTEMI at the Thoraxcenter between 1985 and 2008 were included. Baseline characteristics, pharmacological and invasive treatment modalities, and survival status were collected. The study population was categorised in three groups of patients: those hospitalised between 1985–1990, 1990–2000, and 2000–2008. Results: We identified 14,434 patients hospitalised for myocardial infarction (MI). Both STEMI and NSTEMI patients were increasingly treated with the current guideline based therapy. In STEMI, at 30 days following admission, cumulative mortality rate decreased from 17% in 1985–1990 to 13% in 1990–2000, and to 6% in 2000–2008. Adjusted 30-day and three-year mortality in the last period was 80% and 68% lower than in 1985, respectively. In NSTEMI, at 30 days following admission, cumulative mortality rate decreased from 6% in 1985–1990 to 4% in 1990–2000, and to 2% in 2000–2008. Adjusted 30-day and three-year mortality in the last period was 78% and 49% lower than in 1985, respectively. For patients admitted between 2000 and 2008, 3 year survival of STEMI and NSTEMI patients was 87% and 88%, res