[Evolution of the management and outcomes of patients admitted for acute myocardial infarction in France from 1995 to 2000: data from the USIK 1995 and USIC 2000 nationwide registries].
We assessed the in-hospital management and short- and long-term outcomes of two series of patients admitted for acute myocardial infarction, 5 years apart, in France. The most recent cohort was younger and with a less frequent history of cardiac diseases, but was more often diabetic and with anterior infarcts. Five-day mortality significantly improved from 7.7% to 6.1% (P < 0.03) and 1-year survival was also less in the most recent period (15% versus 19%, P < 0.01). Multivariate analyses showed that the period of inclusion (2000 versus 1995) was an independent predictor of both short- and long-term mortality. In analyses restricted to the patients who were alive by day 5, initial treatment with statins was associated with a 38% decrease in the risk of death at 1 year. Likewise, in patients with left ventricular ejection fraction < or = 35%, the early prescription of ACE inhibitors was associated with a 41% reduction in the risk of 1-year mortality. Thus, in the real world setting, a continued decline in 1-year mortality is observed in patients admitted to intensive care units for recent acute myocardial infarction. This goes along with a shift in reperfusion therapy towards a broader use of coronary angioplasty and with an increased use of the early prescription of recognised secondary prevention medications.
Cambou
J P
JP
Service de cardiologie, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France.
Danchin
N
N
Boutalbi
Y
Y
Hanania
G
G
Humbert
R
R
Clerson
P
P
Vaur
L
L
Guéret
P
P
Blanchard
D
D
Genès
N
N
Lablanche
J M
JM
D000368:Aged; D017130:Angioplasty; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D015331:Cohort Studies; D005260:Female; D005602:France / Q000453:epidemiology; D006761:Hospitals / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends*; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000401:mortality* / Q000628:therapy*; D011379:Prognosis; D012307:Risk Factors; D013318:Stroke Volume; D016896:Treatment Outcome
D000806:Angiotensin-Converting Enzyme Inhibitors