• 作者：Fernando Aró ; s^a ; ^{aborau@secardiologia.es} ; Magda Heras^b ; Joan Vila^c ; ^d ; Hé ; ctor Sanz^c ; Ignacio Ferreira-Gonzá ; lez^d ; ^e ; Gaietà ; Permanyer-Miralda^d ; ^e ; José ; Cu1 ; at^f ; Lorenzo Ló ; pez-Bescó ; s^g ; Adolfo Cabadé ; s^f ; Angel Loma-Osorio^a ; Jaume Marrugat^c ; en representació ; n de los investigadores de los registros PRIAMHO I ; II y MASCARA^&loz ;
• 关键词：ARA-II ; antagonistas del receptor AT-1 de la angiotensina II ; BB ; bloqueadores beta ; GPC ; guí ; as de prá ; ctica clí ; nica ; IAMCEST ; infarto agudo de miocardio con elevació ; n del segmento ST ; IECA ; inhibidor de la enzima de conversi&oa
• 刊名：Revista Espa帽ola de Cardiolog铆a
• 出版年：2011
• 期刊代码：pca308_03008932
• 类别：med
• 出版时间：November 2011
• 卷：64
• 期：11
• 页码：972-980
• 文件大小：261 K

Introduction and objectives

To determine whether mortality from acute myocardial infarction has reduced in Spain and the possibly related therapeutic factors.

Methods

Nine thousand, nine hundred and forty-nine patients with ST-segment elevation myocardial infarction admitted to the Coronary Care Unit were identified from PRIAMHO I, II and MASCARA registries performed in 1995, 2000 and 2005, with a 6 month follow-up.

Results

From 1995 to 2005 patients were increasingly more likely to have hypertension, hyperlipidemia and anterior infarction, but age of onset and the proportion of females did not increase. Twenty-eight-day mortality rates were 12.6%, 12.3%and 6%in 1995, 2000 and 2005 respectively, and 15.3%, 14.6%and 9.4%at 6 months (both P-trend <.001). Multivariate analysis was performed and the adjusted odds ratio for 28-day mortality for an infarction occuring in 2005 (compared with 1995) was 0.62 (95%confidence interval: 0.44-0.88) whereas the adjusted hazard ratio for mortality at 6 months was 0.40 (95%confidence interval: 0.24-0.67). Other variables independently associated with lower mortality at 28 days were: reperfusion therapy, and the use of anti-thrombotic treatment, beta-blockers and angiotensin-converting enzyme inhibitors. The 28-day-6-month period had an independent protective effect on the following therapies: coronary reperfusion, and prescription of antiplatelet agents, beta-blockers and lipid lowering drugs upon discharge.

Conclusions

Twenty-eight-day and six-month mortality rates fell among patients with ST-elevation myocardial infarction in Spain from 1995 to 2005. The possibly related therapeutic factors were the following: more frequent reperfusion therapy and increased use of anti-thrombotic drugs, beta-blockers, angiotensin-converting enzyme inhibitors and lipid lowering drugs.

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