Indikationsstellung zur Herzkatheteruntersuchung nach akutem Myokardinfarkt in Deutschland: Klinische Praxis vs. Richtlinien MITRA-Studie

Abstract

In Germany, patients with acute myocardial infarction are less likely to undergo cardiac catheterization compared to patients in other Western countries (e.g. , the United States). Despite recommended guidelines, invasive strategies are more frequent in low risk groups (younger patients, male gender) than in postinfarction patients at high risk (severely impaired left ventricular function, clinical signs of congestive heart failure, the elderly).

Comparison of primary angioplasty with conservative therapy in patients with acute myocardial infarction and contraindications for thrombolytic therapy

“…MITRA is a German prospective multicenter observational study of the current treatment of acute myocardial infarction, with the aim to treat more patients with established prognostically important and recommended therapies [21]. The aims were to register the current infarction therapy (pilot phase) and to improve individual therapy of the patients by forcing the treating physicians to document why special predefined therapies were not given to the patient (study phase).…”

“…We analyzed the data of the southwestern German ''Maximal Individual Therapy in Acute Myocardial Infarction'' (MITRA) trial [21] to compare patients treated with primary angioplasty to those who did not undergo revascularization (conservative therapy) in patients with acute myocardial infarction and contraindications for thrombolytic therapy.…”

The Impact of Social and Institutional Characteristics on the Appropriateness of Invasive Cardiologic Procedures

“…Der Zugang zu einer adäquaten Versorgung ist für Patienten mit einem niedrigen sozioökonomischen Status häufig schwierig [8,9]. International und auch in Deutschland wurden Frauen seltener als Männer und ältere Patienten seltener als jüngere invasiv untersucht und behandelt [10][11][12]. Für Deutschland ist auch belegt, dass Angehörige höherer (Bildungs-)Schichten häufiger einen Facharzt aufsuchen als Angehörige der unteren Schichten [13].…”