[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].
Observatoire Vendéen indépendant des syndromes Coronarien aigus avec sus-décalage du segment ST (Registre OVISCA). Évaluation départementale, évolution démographique, mortalité, délais de prise en charge.
6-month mortality
Délai préhospitalier
Hospital mortality
Infarctus du myocarde avec sus décalage du segment ST
Mortalité hospitalière
Mortalité à 6 mois
Prehospital delay
Registre
Registry
STEMI
Journal
Annales de cardiologie et d'angeiologie
ISSN: 1768-3181
Titre abrégé: Ann Cardiol Angeiol (Paris)
Pays: France
ID NLM: 0142167
Informations de publication
Date de publication:
Nov 2019
Nov 2019
Historique:
received:
18
03
2019
accepted:
28
08
2019
pubmed:
23
9
2019
medline:
9
4
2020
entrez:
23
9
2019
Statut:
ppublish
Résumé
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. 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). 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). 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.
Identifiants
pubmed: 31542204
pii: S0003-3928(19)30068-X
doi: 10.1016/j.ancard.2019.08.008
pii:
doi:
Types de publication
Journal Article
Langues
fre
Sous-ensembles de citation
IM
Pagination
300-305Informations de copyright
Copyright © 2019 Elsevier Masson SAS. All rights reserved.