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oai:repisalud.isciii.es:20.500.12105/50962024-09-27T09:57:43Zcom_20.500.12105_19604com_20.500.12105_2051col_20.500.12105_19605

00925njm 22002777a 4500 dc Rossello, Xavier author Huo, Yong author Pocock, Stuart author Van de Werf, Frans author Chin, Chee Tang author Danchin, Nicolas author Lee, Stephen W-L author Medina, Jesus author Vega, Ana author Bueno, Hector author 2017 Background: There is a shortage of information on regional variations in ST-segment elevation myocardial infarction (STEMI) management and prognosis at a global level. We aimed to compare patient profiles, in-hospital management and post-discharge mortality across several world regions. Methods: In total, 11,559 patients with STEMI were enrolled in two prospective studies of acute coronary syndrome survivors: EPICOR (4943 patients from 555 hospitals in 20 countries in Europe and Latin America recruited between September 2010 and March 2011) and EPICOR Asia (6616 patients from 218 hospitals in eight Asian countries recruited between June 2011 and May 2012). Comparisons were performed by eight pre-defined regions: Northern Europe (NE), Southern Europe (SE), Eastern Europe (EE), Latin America (LA), China (CN), India (IN), Southeast Asia (SA), and South Korea/Hong Kong/Singapore (KS). Results: Reperfusion therapy rates ranged between 53.9\% (IN) and 81.2\% (SE), primary percutaneous coronary intervention (PCI) between 24.8\% (IN) and 65.6\% (NE) and fibrinolysis between 8.1\% (CN) and 34.2\% (SA). Median time to primary PCI (h) ranged from 3.9 (NE) to 20.9 (IN) and to fibrinolysis from 2.4 (SE) to 6.3 (IN). Two-year mortality ranged between 2.5\% in NE and 7.4\% in LA. Regional variations in mortality persisted after adjustment for reperfusion therapy and known prognostic factors. Conclusions: Among patients with STEMI, there is a wide regional variation in clinical profiles, hospital care and mortality. Substantial room for improvement remains at a global level for increasing reperfusion rates, reducing delays and post-discharge mortality in patients with STEMI. (C) 2017 The Authors. Published by Elsevier Ireland Ltd. IntJ Cardio.2017;245:27-34. 10.1016/j.ijcard.2017.07.039 1874-1754 0167-5273 International Journal of Cardiology 28416795 http://hdl.handle.net/20.500.12105/5096 ST-segment elevation myocardial infarction Early management Reperfusion therapy Regional variation Postdischarge mortality Risk CORONARY SYNDROME PATIENTS TERM-FOLLOW-UP BASE-LINE CHARACTERISTICS LOW-INCOME COUNTRIES CARDIOVASCULAR-DISEASE REPERFUSION THERAPY MIDDLE-INCOME EVENTS GRACE GUIDELINES PATTERNS Global geographical variations in ST-segment elevation myocardial infarction management and post-discharge mortality