Featured Research

from universities, journals, and other organizations

30-day mortality after acute myocardial infarction drops with improved treatment

Date:
August 28, 2012
Source:
European Society of Cardiology (ESC)
Summary:
Improved treatment after acute myocardial infarction and less severe patient profile have reduced 30-day mortality over the past 15 years, according to new research.

Improved treatment after acute myocardial infarction and less severe patient profile have reduced 30-day mortality over the past 15 years, according to research presented at ESC Congress 2012.

Related Articles


The analysis of four French registries from 1995 to 2010 was presented by Professor Nicolas Danchin from the Hopital Europιen Georges Pompidou.

Cardiologists recognize two types of myocardial infarction. The first type, ST-elevation myocardial infarction (STEMI), corresponds to the sudden, permanent occlusion of a coronary artery supplying the myocardium (cardiac muscle), usually manifesting as a prolonged, intense chest pain (what is known as a heart attack); it is a true medical emergency, as prompt reopening of the occluded artery will lead to myocardial salvage and limit the consequences of infarction. The second type, non-ST-segment elevation infarction (NSTEMI), is caused by partial or intermittent blockage of an artery, and leads to a more progressive and more limited destruction of myocardial cells; it does not usually require immediate coronary intervention.

"Over the past 15 years, the global picture of acute myocardial infarction has undergone profound changes," said Professor Danchin. "First, improvements in biological techniques have led to an easier recognition of myocardial cell death, thereby increasing the number of patients with documented myocardial necrosis (i.e. myocardial infarction) considered to have NSTEMI. Second, major changes in patient management have been implemented, following the results of numerous clinical trials in patients with myocardial infarction."

Every five years since 1995 in France, nationwide surveys of patients admitted to intensive care units for acute myocardial infarction during a one-month period have been implemented. Using data from the four registries from 1995 to 2010, the researchers sought to determine:

1) potential changes in the population of patients with heart attacks;

2) changes in their management; and

3) changes in clinical outcomes.

In all, 10,610 patients participated (1995: 2,152; 2000: 2,320; 2005: 3,059; 2010: 3,079). The proportion of patients with NSTEMI (1995: 29%; 2000: 21%; 2005: 47%; 2010 44%) increased after 2000 because of the generalized use of troponin measurements to detect myocardial necrosis. "Previously these patients would have been considered to have unstable angina," said Professor Danchin. "The distinction is important because unstable angina usually carries a lower risk than NSTEMI."

Mean age from 1995 to 2010 remained stable in NSTEMI patients (68 years) and decreased from 66 to 63 years in STEMI patients. From 1995 to 2010 there were increases in the prevalence of obesity (14% to 22%), diabetes (17% to 21%), hypertension (46% to 54%), current smoking (31% to 34%) and hypercholesterolemia (36% to 43%). "Overall, the patient risk profile is less severe in 2010 than in 1995 for both STEMI and NSTEMI patients, although several of the most common risk factors for developing coronary artery disease increased during this time period," said Professor Danchin.

The initial severity of infarction declined progressively, in particular with fewer patients having signs of heart failure. Professor Danchin said: "This could be because of the efficacy of primary prevention in patients with previously recognised risk factors, or secondary prevention in patients with known coronary artery disease."

Major changes in management were noted across all types of myocardial infarction. From 1995 to 2010 the use of percutaneous coronary intervention (PCI) increased from 12.5% to 65% in NSTEMI and from 19.5% to 87% in STEMI. In STEMI, the use of emergency reperfusion therapy to reopen the blocked artery increased from 49% to 75%; primary PCI increased from 12% to 60% and fibrinolysis decreased from 37% to 14%. Early use of evidence based medication increased (antiplatelet agents 91% to 97%, beta-blockers 64% to 81%, statins 14 to 90% and ACE inhibitors 46% to 60%). "This shows that the management of all patients with myocardial infarction has improved, with increasing use of recommended interventions and drug therapies," said Professor Danchin.

Thirty-day mortality dropped during 1995 to 2010 from 12.9% to 3.9% for all acute myocardial infarction patients. It fell from 13.7% to 4.4% in STEMI patients and 10.9% to 3.2% in NSTEMI patients. All in-hospital complications significantly decreased.

"Our analysis shows that the early mortality of both STEMI and NSTEMI patients has considerably decreased over the past 15 years," said Professor Danchin. "Our results suggest that the decreases in 30-day mortality and in-hospital complications are due to both the widespread use of coronary angiography/PCI, and earlier use of recommended medications, and the change in overall clinical presentation of the patients resulting in a decreased intrinsic risk.


Story Source:

The above story is based on materials provided by European Society of Cardiology (ESC). Note: Materials may be edited for content and length.


Cite This Page:

European Society of Cardiology (ESC). "30-day mortality after acute myocardial infarction drops with improved treatment." ScienceDaily. ScienceDaily, 28 August 2012. <www.sciencedaily.com/releases/2012/08/120828073308.htm>.
European Society of Cardiology (ESC). (2012, August 28). 30-day mortality after acute myocardial infarction drops with improved treatment. ScienceDaily. Retrieved November 26, 2014 from www.sciencedaily.com/releases/2012/08/120828073308.htm
European Society of Cardiology (ESC). "30-day mortality after acute myocardial infarction drops with improved treatment." ScienceDaily. www.sciencedaily.com/releases/2012/08/120828073308.htm (accessed November 26, 2014).

Share This


More From ScienceDaily



More Health & Medicine News

Wednesday, November 26, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

From Popcorn To Vending Snacks: FDA Ups Calorie Count Rules

From Popcorn To Vending Snacks: FDA Ups Calorie Count Rules

Newsy (Nov. 25, 2014) — The US FDA is announcing new calorie rules on Tuesday that will require everywhere from theaters to vending machines to include calorie counts. Video provided by Newsy
Powered by NewsLook.com
Daily Serving Of Yogurt Could Reduce Risk Of Type 2 Diabetes

Daily Serving Of Yogurt Could Reduce Risk Of Type 2 Diabetes

Newsy (Nov. 25, 2014) — Need another reason to eat yogurt every day? Researchers now say it could reduce a person's risk of developing type 2 diabetes. Video provided by Newsy
Powered by NewsLook.com
Madagascar Working to Contain Plague Outbreak

Madagascar Working to Contain Plague Outbreak

AFP (Nov. 24, 2014) — Madagascar said Monday it is trying to contain an outbreak of plague -- similar to the Black Death that swept Medieval Europe -- that has killed 40 people and is spreading to the capital Antananarivo. Duration: 00:42 Video provided by AFP
Powered by NewsLook.com
Are Female Bosses More Likely To Be Depressed?

Are Female Bosses More Likely To Be Depressed?

Newsy (Nov. 24, 2014) — A new study links greater authority with increased depressive symptoms among women in the workplace. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
 
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:  

Breaking News:

Strange & Offbeat Stories

 

Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:  

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile iPhone Android Web
Follow Facebook Twitter Google+
Subscribe RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins