Epidemiology of acute myocardial infarction with the emphasis on patients who did not reach the coronary care unit and non-AMI admissions

Herlitz, Johan; Dellborg, Mikael; Karlsson, Thomas; Evander, Maria Haglid; Berger, Alan K.; Luepker, Russell V.

doi:10.1016/j.ijcard.2007.06.018

Cited by 14 publications

(13 citation statements)

References 16 publications

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“…The proportion of patients treated with coronary artery bypass grafting was very low and in agreement with previous findings [ 23 ].…”

Section: Discussionsupporting

confidence: 92%

“…At the time this register covered about ninety percent of all patients hospitalized with AMI under the age of 80 years. Older patients with severe co-morbidity are not always admitted to the CCU and are therefore not included in the register [ 23 ]. This, in combination with the fact that this study only included patients transported with the EMS, may explain the high figure of ST-elevation (58 %).…”

Section: Discussionmentioning

confidence: 99%

“…We assume that the total number of patients admitted to Sahlgrenska University Hospital, and having a final diagnosis of AMI, was about 4000 during the inclusion period. This figure is based on previous surveys [ 23 ]. The relatively large proportion of patients with ST-elevation in our survey suggests that the pre-hospital aspirin-use might have been even lower, had all patients with AMI been included.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Determinants of pre-hospital pharmacological intervention and its association with outcome in acute myocardial infarction

Strandmark

Herlitz

Axelsson

et al. 2015

Scand J Trauma Resusc Emerg Med

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BackgroundThe aim of this study was a) To identify predictors of the use of aspirin in the pre-hospital setting in acute myocardial infarction (AMI) and b) To analyze whether the use of any of the recommended medications was associated with outcome.MethodsAll patients with a final diagnosis of AMI, transported by the Emergency Medical Services (EMS) and admitted to the coronary care unit at Sahlgrenska University Hospital in Gothenburg, Sweden, in 2009–2011, were included.Results1,726 patients were included. 58 % received aspirin by the EMS. Ischemic heart disease (IHD) was suspected in 84 %. Among patients who did not receive aspirin IHD was still suspected in 67 %. Among patients in whom IHD was suspected, and who were not on chronic treatment with aspirin the following predicted its pre-hospital use: a) age (odds ratio 0.98; 95 % confidence interval (CI) 0.96–0.99); b) a history of myocardial infarction (2.21; 1.21–4.04); c) priority given by EMS (8.07; 5.42–12.02); d) ST-elevation on ECG on admission to hospital (2.22; 1.50–3.29); e) oxygen saturation > 90 % (3.37; 1.81–6.27).After adjusting for confounders among patients who were not on chronic aspirin, only nitroglycerin of the recommended medications was associated with a reduced risk of death within 1 year (hazard ratio 0.40; 95 % CI 0.23–0.70).ConclusionsLess than six out of ten patients with AMI received pre-hospital aspirin. Five clinical factors were independently associated with the pre-hospital administration of aspirin. This suggests that the decision to treat is multifactorial, and it highlights the lack of accurate diagnostic tools in the pre-hospital environment.Nitroglycerin was independently associated with a reduced risk of death, suggesting that we select the use for a low-risk cohort.Electronic supplementary materialThe online version of this article (doi:10.1186/s13049-015-0188-x) contains supplementary material, which is available to authorized users.

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“…The proportion of patients treated with coronary artery bypass grafting was very low and in agreement with previous findings [ 23 ].…”

Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Determinants of pre-hospital pharmacological intervention and its association with outcome in acute myocardial infarction

Strandmark

Herlitz

Axelsson

et al. 2015

Scand J Trauma Resusc Emerg Med

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“…One recent study, among several others, suggests that ICD-9-CM coding adequately identifies definite or possible AMIs according to the AHA criteria [30]. The lack of a systematic linkage to a comprehensive mortality registry may be considered a limitation of the study, as patients discharged after AMI could also have died out of the hospital [31]. However, published studies on Italian population registries reported a mortality rate of 8% at one year after discharge, that results in a difference of about 2.8% when compared to our data [24].…”

Section: Limitationsmentioning

confidence: 99%

Trends in mortality and heart failure after acute myocardial infarction in Italy from 2001 to 2011

Greco¹,

Rosato²,

D’Errigo³

et al. 2015

International Journal of Cardiology

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“…The development of coronary heart disease is associated with many pathological factors. 1 Acute myocardial infarction (AMI) is the main cause of sudden death throughout the world, 2 and the timely and effective control of AMI occurrence and development is a primary focus of medical research. Reperfusion therapy is an effective and lifesaving treatment for AMI 3 that results in improved cardiac vascular endothelial function.…”

Section: Introductionmentioning

confidence: 99%

Impairment of vascular endothelial function following reperfusion therapy in patients with acute myocardial infarction

Yang

Kong

et al. 2013

J Int Med Res

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Epidemiology of acute myocardial infarction with the emphasis on patients who did not reach the coronary care unit and non-AMI admissions

Cited by 14 publications

References 16 publications

Determinants of pre-hospital pharmacological intervention and its association with outcome in acute myocardial infarction

Determinants of pre-hospital pharmacological intervention and its association with outcome in acute myocardial infarction

Trends in mortality and heart failure after acute myocardial infarction in Italy from 2001 to 2011

Impairment of vascular endothelial function following reperfusion therapy in patients with acute myocardial infarction

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