Clinical characteristics, hospital care, and prognosis of patients with ST elevation myocardial infarction: Hungarian Myocardial Infarction Registry

Jánosi, András; Ofner, Péter; Forster, Tamás; Édes, István; Tóth, Kálmán; Merkely, Béla

doi:10.1093/eurheartj/sut004

Cited by 13 publications

(11 citation statements)

References 15 publications

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“…The Hungarian Myocardial Infarction Registry (HUMIR) is a prospective, registry collecting clinical data on consecutive patients treated for an AMI in Hungary. The data on capture and follow‐up procedures of the HUMIR has already been published in details previously 4‐7 . Briefly, the patient's data are collected prospectively according to the statute of CCXLVI./2013 of Hungary via a national internet‐based registry.…”

Section: Methodsmentioning

confidence: 99%

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Use of drug‐eluting stents in elderly patients with acute myocardial infarction

et al. 2020

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Background Bare‐metal stents (BMS) are frequently implanted in elderly patients instead of drug‐eluting stents (DES). We aimed to compare the prognosis of patients treated for myocardial infarction with the two types of stents over the age of 75. Methods Data of patients registered in the Hungarian Myocardial Infarction Registry, a mandatory nationwide programme for hospitals treating patients with myocardial infarction were processed. From patients included between January 2014 and December 2017 we created two groups according to DES and BMS implantation. The outcome measures included all‐cause mortality, the composite of cardiac events (MACE), repeated revascularisation and transfusion. Propensity score matching was used to balance the groups and Cox proportional hazards' models to estimate the risk during the 1st year after the index event. Results From 7383 patients (age: 81.08 ± 4.38 years) 3266 (44.2%) patients received DES. The PS‐matched cohort included 5780 cases with balanced characteristics. In the DES group, the mortality (HR 0.66 [0.60‐0.72]), MACE (HR 0.66 [0.60‐0.72]) and the rate of transfusion (HR 0.84 [0.73‐0.97]) were significantly lower. The PS‐matched cohort showed a similar trend but with a lower rate of benefits with a 21% reduction of mortality and 23% of MACE. Difference in transfusion did not reach the level of significance. In multivariate models, stent type prevailed as an independent predictor of mortality and but not of transfusion. Conclusions Based on our analysis of a real‐life, high‐risk population, implantation of DES seems to be an advantageous strategy for elderly patients.

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Section: Methodsmentioning

confidence: 99%

“…Outcome data including vital status and repeated hospitalisations are regularly received from the electronic database of the national healthcare insurance provider 4‐7 . The protocol of the study is in accordance with the Declaration of Helsinki and it was approved by the Hungarian National Committee on Health Research Ethics.…”

Section: Methodsmentioning

confidence: 99%

Use of drug‐eluting stents in elderly patients with acute myocardial infarction

et al. 2020

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“…At the time of the conduction of the present study, the registry operated on a voluntary basis, capturing 51% of AMI cases treated countrywide. [9][10][11] The protocol of the study is in accordance with the Declaration of Helsinki and was reviewed by the ethical board. All patients recorded in the registry gave written informed consent.…”

Section: Methodsmentioning

confidence: 99%

Comparison of Platelet Function Guided Versus Unguided Treatment With P2Y12 Inhibitors in Patients With Acute Myocardial Infarction (from the Hungarian Myocardial Infarction Registry)

Komócsi

Aradi

Tar

et al. 2018

The American Journal of Cardiology

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Evidence is conflicting regarding the clinical benefits of selecting P2Y inhibitors based on platelet function testing (PFT). Between March 1, 2013 and March 1, 2014, we collected clinical characteristics and platelet function data in a nationwide acute myocardial infarction (AMI) registry from 15 interventional cardiology centers in Hungary. The risk of all-cause mortality at 1 year were compared after propensity score (PS) matching between patients receiving PFT-guided and unguided P2Y-inhibitor therapies. High platelet reactivity on clopidogrel (HPRoC) was uniformly defined with the Multiplate assay. A total of 5,583 patients with AMI and coronary intervention were registered. After exclusion of cases with contraindication to prasugrel, propensity matching resulted in a sample of 2,104 patients with well-adjusted characteristics. Clopidogrel was the dominant P2Y inhibitor in both groups (unguided: 96% vs PFT guided: 85%, p <0.001). In the PFT-guided group, 19% of patients had HPRoC and 77% of them were switched to prasugrel. According to the adjusted analysis, all-cause mortality at 1 year was significantly lower in the PFT-guided compared with the unguided group (hazard ratio 0.57 [95% confidence interval 0.43 to 0.77], p <0.001). Although prasugrel treatment was not associated with lower all-cause mortality in the overall cohort, patients with HPRoC who switched to prasugrel had significantly lower mortality when compared with those continuing clopidogrel (hazard ratio 0.33 [95% confidence interval 0.12 to 0.92], p <0.05). In conclusion, in patients with AMI, PFT-guided treatment with a high rate of switchover to prasugrel was associated with a lower risk of mortality. Prasugrel was a predictor of lower mortality in patients with HPRoC but not in the overall cohort of AMI.

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“…A Nemzeti Szívinfarktus Regiszter (NSZR) működésé-nek fontosabb módszertani elemeit korábbi közleménye-inkben ismertettük [1,2]. A prehospitális ellátás és a kór-házi kezelés adatait a webalapú rendszerbe az intézetek online rögzítik.…”

Section: Betegek éS Módszerunclassified

A szívinfarktus miatt kezelt betegek ellátása Magyarországon. A Nemzeti Szívinfarktus Regiszter 2015. évi adatainak elemzése

Jánosi

Ofner

Al-Maktari³

et al. 2017

Orvosi Hetilap

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A szerzők a Nemzeti Szívinfarktus Regiszter 2015. évi adatai alapján ismertetik a szívinfarktusos betegek ellátásának fontosabb hazai adatait. A vizsgált évben 12 681 beteg 12 941 eseményének adatait rögzítették a regiszter adatbázi-sában. A regiszter a finanszírozott kezelések 82%-át tartalmazta. A betegek 44,4%-át ST-elevációval járó szívinfarktus miatt kezelték. A szerzők jelen közleményükben ezen betegcsoport ellátásának adatait elemzik. Az ST-elevációval járó myocardialis infarctus miatt kezeltek több mint felénél (51,4%) az Országos Mentőszolgálat volt az első szakellátó. Prehospitális thrombolysis a betegek 0,23%-ánál történt. A vizsgált infarktusos események 91,6%-ánál a betegek szív-katéteres centrumban kaptak ellátást. A panasz kezdete és a szívkatéteres laboratóriumba kerülés között eltelt idő mediánja 223 perc volt. Az invazív centrumban kezelt -pozitív koronarográfiájú -betegek 94%-ánál percutan coronariaintervenció történt. A 30 napos halálozás az egész betegcsoport esetén 12,8%, míg a katéteres revascularisatió-ban részesült betegek esetén 8,6% volt. A különböző centrumokban (fővárosi vs. vidéki) kezelt betegek 30 napos halálozása nem különbözött. Következtetés: A hazai és a nemzetközi adatok összevetése alapján a prehospitális késés elemzése és csökkentése az elsőrendű feladat az ellátás további javítása érdekében. Orv. Hetil., 2017, 158(3), 90-93. Kulcsszavak: myocardialis infarctus, ST-elevációval járó szívinfarktus, szívinfarktus-regiszter, prognózisPatient care of patients with myocardial infarction in Hungary. Analysis of National Myocardial Infarction Registry data collecting in 2015The authors summarize the most relevant data of myocardial infarction patients according to the National Myocardial Infarction Registry data base. In 2015 12,681 patients had 12,941 acute myocardial infarctions. Less than half of patients (44.4%) were treated with ST elevation myocardial infarction. National Ambulance Service was the first medical contact of more than half (51.4%) of patients with ST elevation infarction. Prehospital thrombolysis was occasionally done (0.23%), but 91.6% of the patients were treated in hospital with invasive facilities. The median of the ischaemic time (time between onset of symptoms and arrival at the invasive laboratory) was 223 minutes. Most of the DOI: 10.1556/650.2017.30670 *A Nemzeti Szívinfarktus Regiszter Vizsgálat résztvevőinek nevében. A név szerint szereplő szerzők olyan intézet/osztály vezetők, akiknél a kezelt betegszám nagyobb, mint 50, és minden finanszírozott beteg regisztrálásra került.

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Clinical characteristics, hospital care, and prognosis of patients with ST elevation myocardial infarction: Hungarian Myocardial Infarction Registry

Cited by 13 publications

References 15 publications

Use of drug‐eluting stents in elderly patients with acute myocardial infarction

Use of drug‐eluting stents in elderly patients with acute myocardial infarction

Comparison of Platelet Function Guided Versus Unguided Treatment With P2Y12 Inhibitors in Patients With Acute Myocardial Infarction (from the Hungarian Myocardial Infarction Registry)

A szívinfarktus miatt kezelt betegek ellátása Magyarországon. A Nemzeti Szívinfarktus Regiszter 2015. évi adatainak elemzése

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