title: Effect of opening a new catheterization laboratory on 30-day and 2-year survival rates in myocardial infarction patients.
abstract: OBJECTIVE
  To determine the effect of opening an on-site diagnostic catheterization facility on 30-day and 2-year mortality rates in patients with myocardial infarction (MI).
  
  
  METHODS
  The study included 1539 consecutive MI patients aged 25-74 years who were recruited before and after the catheterization laboratory opened in 1998: during 1995-1997 and 1999-2003, respectively.
  
  
  RESULTS
  The 641 consecutive MI patients recruited in 1995-1997 had worse 30-day mortality than the 898 recruited between 1999-2003 (11.2% versus 6.35%, respectively; P=.001). The number of coronary angiographies and percutaneous coronary interventions carried out was greater in the second period (19.4% versus 3.3%, and 54.8% versus 23.0%, respectively; P<.001). Two-year survival curves were significantly better in the second period for all-cause and cardiovascular death. The adjusted odds ratio for death at 30 days was 0.58 (95% confidence interval [CI] 0.36-0.95) for the second period compared with the first and the adjusted hazard ratio for cardiovascular death at 2 years for patients still alive at 30 days was 0.62 (95%CI 0.39-0.99). After adjustment for the prescription of statins, angiotensin-converting enzyme inhibitors, beta-blockers and antiplatelet drugs at discharge, the effect observed at 2 years was no longer significant.
  
  
  CONCLUSIONS
  Opening a new on-site diagnostic catheterization unit significantly increased the 30-day survival of MI patients. However, the increase in 2-year survival of 30-day survivors observed was largely explained by the implementation of better secondary prevention.
authors.affiliation: Departamento de Cardiología, Hospital Universitari Dr. Josep Trueta, Girona, España.
authors.forename: Daniel
authors.initials: D
authors.lastname: Bosch
authors.forename: Rafel
authors.initials: R
authors.lastname: Masia
authors.forename: Joan
authors.initials: J
authors.lastname: Sala
authors.forename: Joan
authors.initials: J
authors.lastname: Vila
authors.forename: Rafel
authors.initials: R
authors.lastname: Ramos
authors.forename: Roberto
authors.initials: R
authors.lastname: Elosua
authors.forename: Isaac
authors.initials: I
authors.lastname: Subirana
authors.forename: Magda
authors.initials: M
authors.lastname: Heras
authors.forename: Juan
authors.initials: J
authors.lastname: Sanchis
authors.forename: María
authors.initials: M
authors.lastname: Grau
authors.forename: Ramon
authors.initials: R
authors.lastname: Brugada
authors.forename: Jaume
authors.initials: J
authors.lastname: Marrugat
mesh_terms: D054058:Acute Coronary Syndrome / Q000150:complications; D000328:Adult; D000367:Age Factors; D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D006328:Cardiac Catheterization; D002317:Cardiovascular Agents / Q000627:therapeutic use; D017023:Coronary Angiography; D004562:Electrocardiography; D023381:Endpoint Determination; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007753:Laboratories; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000401:mortality; D012307:Risk Factors; D055502:Secondary Prevention; D012737:Sex Factors; D015996:Survival Rate
chemical_list: D002317:Cardiovascular Agents