[The treatment of myocardial infarction during the hospital stage and shortly thereafter: now and 10 years ago].
OBJECTIVE
Comparison between the early and the late eighties of the application of thrombolysis and revascularisation in the acute phase of a myocardial infarction.


METHODS
University Hospital, Rotterdam.


METHODS
Prospective with historical comparison.


METHODS
All patients admitted between May 1987 and May 1990 with a myocardial infarction and aged up to 71 years were included (n = 430). Numbers of procedures and survival during the following year were compared with data of patients admitted from 1981 to the end of 1983 (n = 706).


RESULTS
In 1981-1983 thrombolytics were administered to 9% of the patients, in 1987-1990 to 40%. Revascularisation procedures during the next year were performed in 17% and 50% of the patients respectively. Hospital mortality decreased from 14% to 10% (p < 0.05), one-year survival increased from 75% to 83% (p < 0.05). For patients from 1987-1990 one-year survival was higher after thrombolysis treatment: 90% versus 78% without (p < 0.01), and after revascularisation: 94% versus 87% without (p < 0.01).


CONCLUSIONS
Compared with 1981-1983 the treatment is at present more directed towards reperfusion and revascularisation of the ischaemic myocardium, resulting in invasive treatment in 50% of the patients now as opposed to 25% in the early eighties. The survival rate during the first year has improved.
Meeter
K
K
Academisch Ziekenhuis Rotterdam-Dijkzigt, Thoraxcentrum.
Honkoop
P
P
Verhage
A H
AH
Boersma
H
H
Fioretti
P
P
Deckers
J W
JW
D000368:Aged; D002985:Clinical Protocols; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality / Q000628:therapy*; D009204:Myocardial Revascularization / Q000706:statistics & numerical data; D009426:Netherlands; D011446:Prospective Studies; D016019:Survival Analysis; D015912:Thrombolytic Therapy / Q000706:statistics & numerical data