Care of patients with ST-elevation myocardial infarction: an international analysis of quality indicators in the acute coronary syndrome STEMI Registry of the EURObservational Research Programme and ACVC and EAPCI Associations of the European Society of Cardiology in 11 462 patients

Peter Ludman*, Uwe Zeymer, Nicolas Danchin, Petr Kala, Cécile Laroche, Masoumeh Sadeghi, Roberto Caporale, Sameh Mohamed Shaheen, Jacek Legutko, Zaza Iakobishvili, Khalid F Alhabib, Zuzana Motovska, Martin Studencan, Jorge Mimoso, David Becker, Dimitrios Alexopoulos, Zviad Kereseselidze, Sinisa Stojkovic, Parounak Zelveian, Artan GodaErkin Mirrakhimov, Gani Bajraktari, Hasan Ali Farhan, Pranas Šerpytis, Bent Raungaard, Toomas Marandi, Alice May Moore, Martin Quinn, Pasi Paavo Karjalainen, Gabriel Tatu-Chitoiu, Chris P. Gale, Aldo P. Maggioni, Franz Weidinger, ACVC EAPCI EORP ACS STEMI investigators group of the ESC, J. Ravkilde (Member of study group), S. E. Jensen (Member of study group), A. Villadsen (Member of study group), K. Villefrance (Member of study group), C. Schmidt Skov (Member of study group)

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review

4 Citations (Scopus)

Abstract

AIMS: To use quality indicators to study the management of ST-segment elevation myocardial infarction (STEMI) in different regions.

METHODS AND RESULTS: Prospective cohort study of STEMI within 24 h of symptom onset (11 462 patients, 196 centres, 26 European Society of Cardiology members, and 3 affiliated countries). The median delay between arrival at a percutaneous cardiovascular intervention (PCI) centre and primary PCI was 40 min (interquartile range 20-74) with 65.8% receiving PCI within guideline recommendation of 60 min. A third of patients (33.2%) required transfer from their initial hospital to one that could perform emergency PCI for whom only 27.2% were treated within the quality indicator recommendation of 120 min. Radial access was used in 56.6% of all primary PCI, but with large geographic variation, from 76.4 to 9.1%. Statins were prescribed at discharge to 98.7% of patients, with little geographic variation. Of patients with a history of heart failure or a documented left ventricular ejection fraction ≤40%, 84.0% were discharged on an angiotensin-converting enzyme inhibitor/angiotensin receptor blocker and 88.7% were discharged on beta-blockers.

CONCLUSION: Care for STEMI shows wide geographic variation in the receipt of timely primary PCI, and is in contrast with the more uniform delivery of guideline-recommended pharmacotherapies at time of hospital discharge.

Original languageEnglish
Article numberzuac143
JournalEuropean Heart Journal: Acute Cardiovascular Care
Volume12
Issue number1
Pages (from-to)22-37
Number of pages16
ISSN2048-8726
DOIs
Publication statusPublished - 27 Jan 2023

Bibliographical note

© The Author(s) 2022. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Keywords

  • Acute Coronary Syndrome/therapy
  • Cardiology
  • Humans
  • Percutaneous Coronary Intervention
  • Prospective Studies
  • Quality Indicators, Health Care
  • Registries
  • ST Elevation Myocardial Infarction/epidemiology
  • Stroke Volume
  • Treatment Outcome
  • Ventricular Function, Left
  • Primary percutaneous coronary intervention
  • Quality indicators
  • Registry
  • Guidelines
  • Reperfusion therapy
  • ST-segment elevation myocardial infarction
  • Observational studies

Fingerprint

Dive into the research topics of 'Care of patients with ST-elevation myocardial infarction: an international analysis of quality indicators in the acute coronary syndrome STEMI Registry of the EURObservational Research Programme and ACVC and EAPCI Associations of the European Society of Cardiology in 11 462 patients'. Together they form a unique fingerprint.

Cite this