Key result
Initial admission to non-PCI hospitals for acute myocardial infarction was associated with an increased risk of 30-day mortality compared to PCI hospitals (aOR 1.88; 95% CI 1.20-2.96).
Why the study?
Acute myocardial infarction is a leading cause of death, but updated data on clinical presentation and current management were lacking in Greece.
Observational (n=1,862)
Yes
Admission to non-PCI hospitals for acute myocardial infarction in Greece is associated with significantly higher in-hospital and 30-day mortality compared to PCI-capable hospitals.
OBJECTIVE: Acute myocardial infarction (AMI) is one of the leading causes of death; however, updated data regarding clinical presentation and current management are missing in Greece. This study aimed to prospectively record the demographic and clinical characteristics of a representative sample of patients suffering from AMI, their management, and short-term outcomes. METHODS: June 2020, consecutive adult patients with STEMI or NSTEMI were enrolled in the 50 participating hospitals, appropriately selected to match the geographical and population distribution in the Greek territory. RESULTS: In total, 1862 patients (mean age: 64.2 ± 13.2 yrs.; 77.2% males) with AMI were enrolled. More patients presented with NSTEMI (56.8%) than with STEMI (43.2%). Primary PCI (pPCI) was the preferable treatment option for STEMI patients in PCI-hospitals (76.9% vs. 39.9% for non-PCI, p < .001) and thrombolysis in non-PCI-hospitals (47.3% vs. 17.9% for PCI-hospitals, p < .001). The mean length of hospital stay was 5.6 days. In-hospital mortality was less likely in NSTEMI compared to that in STEMI patients (aOR = 0.30; 95% CI 0.18 to 0.49). Patients initially admitted in non-PCI-hospitals showed increased risk for in-hospital (aOR = 2.29; 95% CI 1.20 to 4.42) and 30-day mortality (aOR = 1.88; 95% CI 1.20 to 2.96). CONCLUSION: This study shows that the proportion of STEMI and NSTEMI patients managed interventionally has significantly increased, resulting in better clinical outcomes compared to previous Greek surveys.
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Kanakakis et al. (2022) conducted an observational in Acute myocardial infarction (n=1,862). Initial admission to non-PCI-hospitals vs. Initial admission to PCI-hospitals was evaluated on 30-day mortality (aOR 1.88, 95% CI 1.20-2.96). Initial admission to non-PCI hospitals for acute myocardial infarction was associated with an increased risk of 30-day mortality compared to PCI hospitals (aOR 1.88; 95% CI 1.20-2.96).
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