2026-05-21T23:46:08Zhttps://repisalud.isciii.es/rest/oai/requestoai:repisalud.isciii.es:20.500.12105/50962024-09-27T09:57:43Zcom_20.500.12105_19604com_20.500.12105_2051col_20.500.12105_19605
Repisalud
author
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
funder
AstraZeneca
2017-10-20T10:23:09Z
2017-10-20T10:23:09Z
2017
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
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.
eng
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
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GlobalGeographicalVariationsInST-segment_2017.txt