title: Do we reperfuse those in most need? Clinical characteristics of ST-elevation myocardial infarction patients receiving reperfusion therapy in the countrywide registry HELIOS.
abstract: BACKGROUND
  we analysed the clinical profile of patients with an ST-elevation myocardial infarction (STEMI) who arrived in hospital within 12 hrs from pain onset and either received reperfusion therapy (PCI or fibrinolytic therapy) or remained without reperfusion.
  
  
  METHODS
  the Hellenic Infarction Observation Study (HELIOS) 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 all geographical areas.
  
  
  RESULTS
  of 870 patients with STEMI who were admitted within 12 hrs from pain onset, Group A received no reperfusion (n=289, 33.2%), group B underwent primary PCI (n=84, 9.7%) and group C received fibrinolysis (n=497, 57.1%). In groups A, B and C, respectively, mean age was 73 ± 13, 61 ± 12 and 62 ± 13 years (p<0.001). The prevalence of female sex was 33%, 14%, 18%, of diabetes 40%, 23%, 21%, of prior MI 23%, 10%, 11% and of Killip class 2-4 at admission 32%, 11%, 13%, respectively (all p<0.001). In a multivariate analysis, advanced Killip class, age, diabetes and pain to admission time >3 hrs were all independent variables related to no reperfusion therapy.
  
  
  CONCLUSIONS
  reperfusion therapies are applied to relatively lower-risk patients. If a survival advantage is to be expected at the national level, more high-risk patients, such as the elderly, women, diabetics, and mainly those with advanced Killip class, should be considered for reperfusion strategies.
authors.affiliation: Hygeia Hospital, Athens, Greece. a.pipilis@hygeia.gr
authors.forename: Athanasios
authors.initials: A
authors.lastname: Pipilis
authors.forename: George
authors.initials: G
authors.lastname: Andrikopoulos
authors.forename: John
authors.initials: J
authors.lastname: Lekakis
authors.forename: Alexandros
authors.initials: A
authors.lastname: Gotsis
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Oikonomou
authors.forename: Konstantina
authors.initials: K
authors.lastname: Toli
authors.forename: Christos
authors.initials: C
authors.lastname: Kyrpizidis
authors.forename: Stylianos
authors.initials: S
authors.lastname: Lambropoulos
authors.forename: Leandros
authors.initials: L
authors.lastname: Stefanatos
authors.forename: Georgios
authors.initials: G
authors.lastname: Goumas
authors.forename: George
authors.initials: G
authors.lastname: Kochiadakis
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Koutsogiannis
authors.forename: Antonios
authors.initials: A
authors.lastname: Kassimatis
authors.forename: Ioannis
authors.initials: I
authors.lastname: Kogias
authors.forename: Athanasios
authors.initials: A
authors.lastname: Kartalis
authors.forename: Vasilios
authors.initials: V
authors.lastname: Kostopoulos
authors.forename: John
authors.initials: J
authors.lastname: Goudevenos
authors.lastname: HELIOS Group
mesh_terms: D015906:Angioplasty, Balloon, Coronary; D006115:Greece; D006801:Humans; D009203:Myocardial Infarction / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D015425:Myocardial Reperfusion; D012042:Registries; D015912:Thrombolytic Therapy