Management of acute myocardial infarction in intensive care units in 1995: a nationwide French survey of practice and early hospital results
N Danchin,
L Vaur,
N Genes,
M Renault,
J Ferrieres,
S Etienne,
and
JP Cambou
Service de Cardiologie A, Centre Hospitalier Universitaire Nancy-Brabois, Vandoeuvre-les-Nancy, France. n.danchin@chu-nancy.fr
OBJECTIVES: This survey sought to determine actual practices in the management of acute myocardial infarction on a nationwide scale. BACKGROUND: Few data are available regarding the adoption of clinical trial results of treatment of myocardial infarction into "real-world" clinical practice. METHODS: Of 501 intensive care units in France, 373 (74%) collected data from all patients with myocardial infarction admitted within 48 h of symptom onset during November 1995. RESULTS: Data from 2,563 patients (71% men; mean age [+/-SD] 67 +/- 14 years) were included. Time from symptom onset to admission was <6 h in 1,467 patients (62%). Thrombolysis was used in 822 patients (32%) and primary angioplasty in 330 (13%). The use of reperfusion therapy decreased markedly with age. During the first 5 days, heparin was prescribed in 96% of patients, aspirin in 89%, nitrates in 87%, beta-adrenergic blocking agents in 64%, angiotensin-converting enzyme inhibitors in 46% and calcium antagonists in 17%. Coronary angiography was performed in 33% of patients, and 58% had echocardiographic assessment of left ventricular ejection fraction (LVEF). Median LVEF was 50%. The 5-day mortality rate was 7.7% compared with 12.1% in a previous French survey carried out in 1984. By multivariate analysis, independent predictors of mortality were age, anterior infarction, history of stroke and heart failure and, when added to the model, Killip class and LVEF. CONCLUSIONS: This survey shows that the results of therapeutic trials have largely translated to clinical practice, resulting in improved early outcome compared with the early 1980s. However, continuous efforts should be made to shorten the time delay before hospital admission and to increase the proportion of elderly patients receiving reperfusion therapy.
This article has been cited by other articles:
|
|
|
|
 
N. Danchin, P. Coste, J. Ferrieres, P.-G. Steg, Y. Cottin, D. Blanchard, L. Belle, B. Ritz, G. Kirkorian, M. Angioi, et al.
Comparison of Thrombolysis Followed by Broad Use of Percutaneous Coronary Intervention With Primary Percutaneous Coronary Intervention for ST-Segment-Elevation Acute Myocardial Infarction: Data From the French Registry on Acute ST-Elevation Myocardial Infarction (FAST-MI)
Circulation,
July 15, 2008;
118(3):
268 - 276.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
P G Steg, J-P Cambou, P Goldstein, E Durand, P Sauval, Z Kadri, D Blanchard, J-M Lablanche, P Gueret, Y Cottin, et al.
Bypassing the emergency room reduces delays and mortality in ST elevation myocardial infarction: the USIC 2000 registry
Heart,
October 1, 2006;
92(10):
1378 - 1383.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
The ESHRE Capri Workshop Group
Hormones and cardiovascular health in women
Hum. Reprod. Update,
September 1, 2006;
12(5):
483 - 497.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
Z Kadri, N Danchin, L Vaur, Y Cottin, P Gueret, M Zeller, J-M Lablanche, D Blanchard, G Hanania, N Genes, et al.
Major impact of admission glycaemia on 30 day and one year mortality in non-diabetic patients admitted for myocardial infarction: results from the nationwide French USIC 2000 study
Heart,
July 1, 2006;
92(7):
910 - 915.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. Simon, M. Mary-Krause, J.-P. Cambou, G. Hanania, P. Gueret, J.-M. Lablanche, D. Blanchard, N. Genes, N. Danchin, and on behalf of the USIC Investigators
Impact of age and gender on in-hospital and late mortality after acute myocardial infarction: increased early risk in younger women: Results from the French nation-wide USIC registries
Eur. Heart J.,
June 1, 2006;
27(11):
1282 - 1288.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
G Hanania, J-P Cambou, P Gueret, L Vaur, D Blanchard, J-M Lablanche, Y Boutalbi, R Humbert, P Clerson, N Genes, et al.
Management and in-hospital outcome of patients with acute myocardial infarction admitted to intensive care units at the turn of the century: results from the French nationwide USIC 2000 registry
Heart,
December 1, 2004;
90(12):
1404 - 1410.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
N. Danchin, D. Blanchard, P. G. Steg, P. Sauval, G. Hanania, P. Goldstein, J.-P. Cambou, P. Gueret, L. Vaur, Y. Boutalbi, et al.
Impact of Prehospital Thrombolysis for Acute Myocardial Infarction on 1-Year Outcome: Results From the French Nationwide USIC 2000 Registry
Circulation,
October 5, 2004;
110(14):
1909 - 1915.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
L. N. Graham, P. A. Smith, R. J. Huggett, J. B. Stoker, A. F. Mackintosh, and D. A.S.G. Mary
Sympathetic Drive in Anterior and Inferior Uncomplicated Acute Myocardial Infarction
Circulation,
May 18, 2004;
109(19):
2285 - 2289.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
F. Lopez-Jimenez, T. Y. Goraya, J. P. Hellermann, S. J. Jacobsen, G. S. Reeder, S. A. Weston, and V. L. Roger
Measurement of Ejection Fraction After Myocardial Infarction in the Population
Chest,
February 1, 2004;
125(2):
397 - 403.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. E. Bertrand and E. McFadden
Cardiogenic shock: is there light at the end of the tunnel?
J. Am. Coll. Cardiol.,
October 15, 2003;
42(8):
1387 - 1388.
[Full Text]
[PDF]
|
|
|
|
|
|
|
N Danchin, O Grenier, J Ferrieres, C Cantet, and J-P Cambou
Use of secondary preventive drugs in patients with acute coronary syndromes treated medically or with coronary angioplasty: results from the nationwide French PREVENIR survey
Heart,
August 1, 2002;
88(2):
159 - 162.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
G. de Gevigney, R. Ecochard, M. Rabilloud, S. Gaillard, E. Cheneau, C. Ducreux, D. Cao, H. Milon, F. Delahaye, and PRIMA group
Worsening of heart failure during hospital course of an unselected cohort of 2507 patients with myocardial infarction is a factor of poor prognosis: the PRIMA study
Eur J Heart Fail,
March 1, 2001;
3(2):
233 - 241.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
K.A.A Fox, D.V Cokkinos, J Deckers, U Keil, A Maggioni, and G Steg
The ENACT study: a pan-European survey of acute coronary syndromes
Eur. Heart J.,
September 1, 2000;
21(17):
1440 - 1449.
[Abstract]
[PDF]
|
|
|
|
|
|
|
S Gottlieb, U Goldbourt, V Boyko, D Harpaz, L Mandelzweig, Z Khoury, S Stern, S Behar, and for the SPRINT and Israeli Thrombolytic Survey Gro
Mortality trends in men and women with acute myocardial infarction in coronary care units in Israel. A comparison between 1981-1983 and 1992-1994
Eur. Heart J.,
February 2, 2000;
21(4):
284 - 295.
[Abstract]
[PDF]
|
|
|
|
|
|
|
S. Gottlieb, V. Boyko, D. Harpaz, H. Hod, M. Cohen, L. Mandelzweig, Z. Khoury, S. Stern, S. Behar, and for the Israeli Thrombolytic Survey Group
Long-term (three-year) prognosis of patients treated with reperfusion or conservatively after acute myocardial infarction
J. Am. Coll. Cardiol.,
July 1, 1999;
34(1):
70 - 82.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
N. Danchin, L. Vaur, N. Genes, S. Etienne, M. Angioi, J. Ferrieres, and J.-P. Cambou
Treatment of Acute Myocardial Infarction by Primary Coronary Angioplasty or Intravenous Thrombolysis in the "Real World" : One-Year Results From a Nationwide French Survey
Circulation,
May 25, 1999;
99(20):
2639 - 2644.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. R McMechan and A A J. Adgey
Age related outcome in acute myocardial infarction
BMJ,
November 14, 1998;
317(7169):
1334 - 1335.
[Full Text]
|
|
|
|
