• 作者：Daniel Bosch^a ; Rafel Masia^a ; Joan Sala^a ; Joan Vila^b ; Rafel Ramos^c ; Roberto Elosua^b ; ^d ; Isaac Subirana^b ; ^d ; Magda Heras^e ; Juan Sanchis^f ; Marí ; a Grau^b ; Ramon Brugada^a ; ^g ; Jaume Marrugat^b ; ^{jmarrugat@imim.es} ; los investigadores del REGICOR^&loz ;
• 关键词：CABG ; Cirugí ; a de bypass arterial coronario ; EC ; Enfermedad cardiovascular ; IAM ; Infarto agudo de miocardio ; ICP ; Intervencionismo coronario percut&aacute ; neo ; IM ; Infarto de miocardio ; SCA ; Sí ; ndrome coronario agudo
• 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：February 2011
• 卷：64
• 期：2
• 页码：96-104
• 文件大小：188 K

Introduction and objectives

To determine the effect of opening an on-site diagnostic catheterization facility on 30-day and 2-year mortality rates in patients with myocardial infarction (MI).

Methods

The study included 1539 consecutive MI patients aged 25鈥?4 years who were recruited before and after the catheterization laboratory opened in 1998: during 1995鈥?997 and 1999鈥?003, respectively.

Results

The 641 consecutive MI patients recruited in 1995鈥?997 had worse 30-day mortality than the 898 recruited between 1999鈥?003 (11.2%versus 6.35%, respectively; P = .001). The number of coronary angiographies and percutaneous coronary interventions carried out was greater in the second period (19.4%versus 3.3%, and 54.8%versus 23.0%, respectively; P < .001). Two-year survival curves were significantly better in the second period for all-cause and cardiovascular death. The adjusted odds ratio for death at 30 days was 0.58 (95%confidence interval [CI] 0.36鈥?.95) for the second period compared with the first and the adjusted hazard ratio for cardiovascular death at 2 years for patients still alive at 30 days was 0.62 (95%CI 0.39鈥?.99). After adjustment for the prescription of statins, angiotensin-converting enzyme inhibitors, beta-blockers and antiplatelet drugs at discharge, the effect observed at 2 years was no longer significant.

Conclusions

Opening a new on-site diagnostic catheterization unit significantly increased the 30-day survival of MI patients. However, the increase in 2-year survival of 30-day survivors observed was largely explained by the implementation of better secondary prevention.

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