[Do on-site coronary angiographic facilities influence management and prognosis of acute myocardial infarction?].
Whether the presence of on-site coronary angiographic facilities (CAF) influences the use of invasive coronary procedures and the outcome of acute myocardial infarction in coronary care units was studied. A prospective survey was conducted early in 1992 when 1014 consecutive patients with acute infarction were admitted. Of them 707 (70%) were admitted to coronary care units of hospitals with, and 307 (30%) without CAF. Thrombolytic therapy was given to 46% in both groups. Those admitted to hospitals with CAF underwent more coronary angiographies (26%) and percutaneous transluminal angiography and/or coronary artery bypass grafting (12%) than those without CAF (10 and 5%, respectively--p < 0.005). In-hospital and 1-year mortality were 11 and 18% respectively in those with CAF, vs 10 and 11%, respectively, in those without CAF. All patients treated with a thrombolytic agent had similar mortality, unrelated to the availability of CAF. The survey showed that the availability of on-site coronary angiography facilities led to greater use of invasive coronary procedures in cases of acute myocardial infarction, but there was no significant difference in mortality.
Behar
S
S
Israel Thrombolytic Study Group, Neufeld Cardiac Research Institute, Chaim Sheba Medical Center, Tel Hashomer.
Hod
H
H
Benari
B
B
Narinsky
R
R
Pauzner
H
H
Rechavia
E
E
Faibel
H
H
Katz
A
A
Roth
A
A
Goldhammer
E
E
D015906:Angioplasty, Balloon, Coronary; D017023:Coronary Angiography / Q000706:statistics & numerical data; D001026:Coronary Artery Bypass; D003325:Coronary Care Units; D006297:Health Services Accessibility; D017052:Hospital Mortality; D006760:Hospitalization; D006801:Humans; D009203:Myocardial Infarction / Q000000981:diagnostic imaging* / Q000401:mortality / Q000628:therapy*; D011379:Prognosis; D015912:Thrombolytic Therapy