title: Outcome of patients with acute myocardial infarction admitted in hospitals with or without catheterization laboratory: results from the HELIOS registry.
abstract: OBJECTIVE
  To compare the treatment and outcomes of myocardial infarction patients in hospitals with and without catheterization laboratory.
  
  
  RESULTS
  The Hellenic Infarction Observation Study was a countrywide registry of acute myocardial infarction, conducted during 2005-2006. The registry enrolled 1840 patients with myocardial infarction from 31 hospitals with a proportional representation of all types of hospitals and of all geographical areas. Out of these patients, 645 (35%) were admitted in 11 hospitals with and 1195 (65%) in 20 hospitals without catheterization laboratory. Patients admitted in hospitals with catheterization laboratory in comparison with patients admitted in hospitals without were younger (66+/-14 vs. 68+/-13, P<0.004) with less diabetes (27 vs. 33%, P<0.001), but without other baseline differences (female 27 vs. 25%, prior myocardial infarction 20 vs. 17%, Killip class>1 22 vs. 23%). Reperfusion rates for ST-segment elevation myocardial infarction were 67% (43% lytic, 24% primary percutaneous coronary interventions) versus 56% (55% lytic, 1% percutaneous coronary interventions; P<0.01). In-hospital outcomes in hospitals with versus in hospitals without laboratory were: mortality 6.5 versus 8.3% (NS), stroke 2.2 versus 1.1% (NS), major bleeding 1.1 versus 0.6% (NS), and heart failure 11 versus 16% (P<0.01). In multivariate regression analysis, being admitted in a hospital without catheterization laboratory was not an independent predictor of increased in-hospital mortality (odds ratio=1.18, 95% confidence interval: 0.72-1.93, P=0.505).
  
  
  CONCLUSIONS
  Although the majority of acute myocardial infarction patients was admitted in hospitals without catheterization laboratory, these patients do not have a survival disadvantage, provided they are treated with lytic therapy, medical secondary prevention drugs, and eventual revascularization according to current guidelines.
authors.affiliation: Hygeia Hospital, Athens, Greece. a.pipilis@hygeia.gr
authors.forename: Athanasios
authors.initials: A
authors.lastname: Pipilis
authors.forename: Georgios
authors.initials: G
authors.lastname: Andrikopoulos
authors.forename: John
authors.initials: J
authors.lastname: Lekakis
authors.forename: Kallirroi
authors.initials: K
authors.lastname: Kalantzi
authors.forename: Anastasia
authors.initials: A
authors.lastname: Kitsiou
authors.forename: Konstantina
authors.initials: K
authors.lastname: Toli
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Floros
authors.forename: Dan
authors.initials: D
authors.lastname: Gaita
authors.forename: Ioannis
authors.initials: I
authors.lastname: Karalis
authors.forename: Spyridon
authors.initials: S
authors.lastname: Dragomanovits
authors.forename: Petros
authors.initials: P
authors.lastname: Kalogeropoulos
authors.forename: Andreas
authors.initials: A
authors.lastname: Synetos
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Koutsogiannis
authors.forename: Pavlos
authors.initials: P
authors.lastname: Stougiannos
authors.forename: Chariton
authors.initials: C
authors.lastname: Antonakoudis
authors.forename: John
authors.initials: J
authors.lastname: Goudevenos
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000368:Aged; D000787:Angina Pectoris / Q000453:epidemiology; D015906:Angioplasty, Balloon, Coronary; D047228:Angiotensin II Type 1 Receptor Blockers / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D000925:Anticoagulants / Q000627:therapeutic use; D006328:Cardiac Catheterization; D004363:Drug Utilization; D005260:Female; D006115:Greece / Q000453:epidemiology; D006268:Health Facilities / Q000706:statistics & numerical data*; D006333:Heart Failure / Q000453:epidemiology; D006493:Heparin / Q000627:therapeutic use; D006760:Hospitalization; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D008297:Male; D009203:Myocardial Infarction / Q000453:epidemiology / Q000628:therapy*; D015425:Myocardial Reperfusion; D017063:Outcome Assessment, Health Care; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D012008:Recurrence; D012042:Registries; D012769:Shock / Q000453:epidemiology; D020521:Stroke / Q000453:epidemiology
chemical_list: D000319:Adrenergic beta-Antagonists; D047228:Angiotensin II Type 1 Receptor Blockers; D000806:Angiotensin-Converting Enzyme Inhibitors; D000925:Anticoagulants; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D010975:Platelet Aggregation Inhibitors; D006493:Heparin