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Geen voordeel voor patiënten met een acuut myocardinfarct die vanuit een algemeen ziekenhuis verwezen werden naar een interventiecentrum voor dotterbehandeling; vergelijking van mortaliteitscijfers van 2000 en 2003 in het meander medisch centrum, amersfoort
| Content Provider | Semantic Scholar |
|---|---|
| Author | Tabbers, F. C. A. Nagtegaal, J. Elsbeth Landman, Marcel A. J. Westerlaken, Michelle |
| Copyright Year | 2006 |
| Abstract | Objective. To evaluate whether implementation of the 200I Netherlands Society of Cardiology guideline 'ST-elevation acute coronary syndromes', which recommends the use of percutaneous coronary intervention (PCI), has reduced mortality and complication rates in a general hospital, and whether patient characteristics and outcomes are comparable to those reported in the Assessment of the Safety and Efficacy of New Thrombolytic (ASSENT) 2 and 3 trials. Design. Retrospective outcomes study. Method. Data from 2003 were compared with data from 2000 regarding patients with acute myocardial infarction who received thrombolysis at the Meander Medical Centre in Amersfoort, the Netherlands, or percutaneous transluminal coronary angioplasty (PTCA) after referral to an intervention clinic. Data included baseline characteristics, type of treatment, outcomes and complications. Age, sex and mortality of all patients were compared to data from the ASSENT 2 and 3 trials. Results. Data were included from I30/I32 patients treated in 2003 and I45/I45 patients treated in 2000. Baseline characteristics were comparable, except age: there were significant more elderly patients in 2003 (p = 0.006). After implementation of the guideline, significantly more patients underwent PTCA (odds ratio (OR) 4.41 (95% CI: 2.51-7.75)). After adjusting for confounding factors there was no significant difference in in-hospital mortality (adjusted OR I.II (95% CI: 0.48-2.60)), 30-day mortality and I-year mortality. Significantly more minor complications were reported (OR 2.58 (95% CI: I.07-6.I9)). Significantly more women and patients older than 75 years were treated compared with the ASSENT 2 and 3 trials. The 30-day mortality rate was significantly higher compared with ASSENT 2 (ORI.60 (95% CI: I.07-2.4I)) and ASSENT 3 (OR I.74 (95% CI: 1.14-2.66)). Conclusion. The implementation of new guidelines 'ST-elevation acute coronary syndromes' did not result in lower mortality or fewer complications. |
| Starting Page | 2705 |
| Ending Page | 2710 |
| Page Count | 6 |
| File Format | PDF HTM / HTML |
| Volume Number | 150 |
| Alternate Webpage(s) | https://www.ntvg.nl/system/files/publications/2006127050001a.pdf |
| Language | English |
| Access Restriction | Open |
| Content Type | Text |
| Resource Type | Article |
