What question did this study set out to answer?

To evaluate longitudinal trends in the application of evidence-based medical and invasive therapies and their relationship with short-term survival across different electrocardiographic presentations of acute myocardial infarction.

April 4, 2008Journal of Internal Medicine

20‐year trends in clinical characteristics, therapy and short‐term prognosis in acute myocardial infarction according to presenting electrocardiogram: the MONICA / KORA AMI Registry (1985–2004)

View Full Paper

Ask AI

Bookmark

Why the study?

Does the increased use of evidence-based pharmacological and interventional therapies over time improve short-term prognosis in patients with acute myocardial infarction?

Population

6748 consecutive patients with acute myocardial infarction aged 25-74 years hospitalized in the study…

Comparison

Evidence-based pharmacological therapy and… vs Earlier time periods compared to the latest period

Design

Cohort

Follow-up

28 days

Authors

BKBernhard KuchSüdharz Klinikum MHMargit HeierPreventive Cardiology WSWolfgang von ScheidtUniversity Hospital Augsburg

Discussion

Member takes

Implication

Declines in 28-day AMI fatality may encourage continued therapy uptake; leaves open causal roles in bundle branch block.

Key Points

To evaluate longitudinal trends in the application of evidence-based medical and invasive therapies and their relationship with short-term survival across different electrocardiographic presentations of acute myocardial infarction.
Analyzed prospective registry data from 6,748 consecutive hospitalized patients with acute myocardial infarction aged 25–74 years between 1985 and 2004.
Stratified patients across four consecutive time intervals: 1985–1989 (n = 1,622), 1990–1994 (n = 1,588), 1995–1999 (n = 1,450), and 2000–2004 (n = 2,088) by electrocardiogram presentation.
Use of percutaneous coronary intervention and coronary artery bypass graft expanded rapidly from 30% and 15% in 1998 to 66.0% and 22% in 2004, respectively, alongside substantial upticks in evidence-based pharmacological treatments.
In-hospital complications and 28-day case fatality fell across all acute myocardial infarction groups, with the sharpest mortality decline observed in patients with bundle branch block (from 25.3% to 10.3%, P < 0.001).
Adjusting for recanalization therapy attenuated the 28-day case fatality odds reduction among patients with bundle branch block from OR 0.35 (95% CI: 0.16–0.74) to OR 0.52 (95% CI: 0.19–1.45).

Structured PICO

Does the increased use of evidence-based pharmacological and interventional therapies over time improve short-term prognosis in patients with acute myocardial infarction?

Population

6748 consecutive patients with acute myocardial infarction (AMI) aged 25-74 years hospitalized in the study region's major clinic, stratified into four time-periods (1985-2004).

Intervention

Evidence-based pharmacological therapy and invasive procedures (percutaneous coronary intervention and coronary artery bypass graft) over time

Comparator

Earlier time periods (1985-1989, 1990-1994, 1995-1999) compared to the latest period (2000-2004)

Outcome

In-hospital complications and 28-day-case fatalityhard clinical

Over a 20-year period, increased use of evidence-based pharmacological and interventional therapies for AMI was associated with significant reductions in in-hospital complications and 28-day mortality, particularly in patients presenting with bundle branch block.

Cite This Study

Kuch et al. (2008) studied this question.

synapsesocial.com/papers/6a8217f2f10a9fcdd646be25 https://doi.org/10.1111/j.1365-2796.2008.01956.x

View Full Paper

Ask AI

Bookmark

20‐year trends in clinical characteristics, therapy and short‐term prognosis in acute myocardial infarction according to presenting electrocardiogram: the MONICA / KORA AMI Registry (1985–2004)

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

20‐year trends in clinical characteristics, therapy and short‐term prognosis in acute myocardial infarction according to presenting electrocardiogram: the MONICA / KORA AMI Registry (1985–2004)

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Also Consider