Aims  The aim of this study was to determine the contemporary use of reperfusion therapy in the European Society of Cardiology (ESC) member and affiliated countries and adherence to ESC clinical practice guidelines in patients with ST-elevation myocardial infarction (STEMI). Methods and results  Prospective cohort (EURObservational Research Programme STEMI Registry) of hospitalized STEMI patients with symptom onset <24 h in 196 centres across 29 countries. A total of 11 462 patients were enrolled, for whom primary percutaneous coronary intervention (PCI) (total cohort frequency: 72.2%, country frequency range 0–100%), fibrinolysis (18.8%; 0–100%), and no reperfusion therapy (9.0%; 0–75%) were performed. Corresponding in-hospital mortality rates from any cause were 3.1%, 4.4%, and 14.1% and overall mortality was 4.4% (country range 2.5–5.9%). Achievement of quality indicators for reperfusion was reported for 92.7% (region range 84.8–97.5%) for the performance of reperfusion therapy of all patients with STEMI <12 h and 54.4% (region range 37.1–70.1%) for timely reperfusion. Conclusions  The use of reperfusion therapy for STEMI in the ESC member and affiliated countries was high. Primary PCI was the most frequently used treatment and associated total in-hospital mortality was below 5%. However, there was geographic variation in the use of primary PCI, which was associated with differences in in-hospital mortality.

Background: Survivors of acute myocardial infarction(AMI) struggle with stressful consequences. Sense of coherence(SOC) seems to be associated with a person's capacity to face life incidents. The current study aims to evaluate SOC's correlation with the major adverse cardiac events(MACE) among the AMI survivors. The study was designed and reported following the STROBE guidelines and checklist.Methods: This study was part of the ST-elevated myocardial infarction cohort study in Isfahan(SEMI-CI) conducted on 724 AMI survivors followed for two years. The patients' demographic, medical history and follow-up manifestations were recruited. The 13-item SOC questionnaire was utilized and the Diagnostic Criteria for Psychosomatic Research(DCPR) questionnaire for psychosomatic disorders evaluation, including health anxiety, illness denial, irritable mood, and demoralization. MACE was defined as non-fatal MI, non-fatal stroke, and atherosclerosis cardiovascular disease-related death was recorded. Results: Logistic regression assessments showed that the SOC level was an independent predictor for the development of MACE(OR:0.67; 95%CI:0.40-0.85). This finding was confirmed by the controlling factors, including demographic data(OR:0.60; 95%CI:0.35-0.79), demographic factors and medical history(OR:0.62; 95%CI:0.36-0.86), the previous ones plus clinical follow-up assessments(OR:0.59; 95%CI:0.33-0.79), and all the evaluations plus psychosomatic factors(OR:0.76; 95%CI:0.42-0.92). Similar outcomes were achieved using SOC scores.Conclusion: Based on this study, SOC was an independent MACE predictor in a large population of AMI patients through a 2-year-follow-up period.

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