title: [Reduction in 28 days and 6 months of acute myocardial infarction mortality from 1995 to 2005. Data from PRIAMHO I, II and MASCARA registries].
abstract: OBJECTIVE
  To determine whether mortality from acute myocardial infarction has reduced in Spain and the possibly related therapeutic factors.
  
  
  METHODS
  Nine thousand, nine hundred and forty-nine patients with ST-segment elevation myocardial infarction admitted to the Coronary Care Unit were identified from PRIAMHO I, II and MASCARA registries performed in 1995, 2000 and 2005, with a 6 month follow-up.
  
  
  RESULTS
  From 1995 to 2005 patients were increasingly more likely to have hypertension, hyperlipidemia and anterior infarction, but age of onset and the proportion of females did not increase. Twenty-eight-day mortality rates were 12.6%, 12.3% and 6% in 1995, 2000 and 2005 respectively, and 15.3%, 14.6% and 9.4% at 6 months (both P-trend <.001). Multivariate analysis was performed and the adjusted odds ratio for 28-day mortality for an infarction occuring in 2005 (compared with 1995) was 0.62 (95% confidence interval: 0.44-0.88) whereas the adjusted hazard ratio for mortality at 6 months was 0.40 (95% confidence interval: 0.24-0.67). Other variables independently associated with lower mortality at 28 days were: reperfusion therapy, and the use of anti-thrombotic treatment, beta-blockers and angiotensin-converting enzyme inhibitors. The 28-day-6-month period had an independent protective effect on the following therapies: coronary reperfusion, and prescription of antiplatelet agents, beta-blockers and lipid lowering drugs upon discharge.
  
  
  CONCLUSIONS
  Twenty-eight-day and six-month mortality rates fell among patients with ST-elevation myocardial infarction in Spain from 1995 to 2005. The possibly related therapeutic factors were the following: more frequent reperfusion therapy and increased use of anti-thrombotic drugs, beta-blockers, angiotensin-converting enzyme inhibitors and lipid lowering drugs.
authors.affiliation: Servicio de Cardiología, Hospital Txagorritxu, José Atxotegi, s/n, 01009 Vitoria-Gasteiz, Álava, España.
authors.forename: Fernando
authors.initials: F
authors.lastname: Arós
authors.forename: Magda
authors.initials: M
authors.lastname: Heras
authors.forename: Joan
authors.initials: J
authors.lastname: Vila
authors.forename: Héctor
authors.initials: H
authors.lastname: Sanz
authors.forename: Ignacio
authors.initials: I
authors.lastname: Ferreira-González
authors.forename: Gaietà
authors.initials: G
authors.lastname: Permanyer-Miralda
authors.forename: José
authors.initials: J
authors.lastname: Cuñat
authors.forename: Lorenzo
authors.initials: L
authors.lastname: López-Bescós
authors.forename: Adolfo
authors.initials: A
authors.lastname: Cabadés
authors.forename: Angel
authors.initials: A
authors.lastname: Loma-Osorio
authors.forename: Jaume
authors.initials: J
authors.lastname: Marrugat
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D003422:Critical Care; D019468:Disease Management; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006801:Humans; D006949:Hyperlipidemias / Q000150:complications / Q000453:epidemiology; D006973:Hypertension / Q000150:complications / Q000453:epidemiology; D000960:Hypolipidemic Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000401:mortality* / Q000628:therapy*; D016017:Odds Ratio; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D016016:Proportional Hazards Models; D012042:Registries; D012737:Sex Factors; D013030:Spain / Q000453:epidemiology
chemical_list: D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D005343:Fibrinolytic Agents; D000960:Hypolipidemic Agents; D010975:Platelet Aggregation Inhibitors