title: [Treatment of ST-segment elevation acute myocardial infarction in hospitals with and without cardiac catheterization laboratory].
abstract: OBJECTIVE
  The goal of treatment of patients with ST-segment elevation acute myocardial infarction (STEMI) is to restore perfusion as soon as possible, preferably by primary percutaneous coronary intervention (PCI). The aim of this study of the German Myocardial Infarction Registry (DHR) was to document acute care and in-hospital course of STEMI patients in Germany.
  
  
  METHODS
  Over three months patients with STEMI were consecutively included and their basic data, treatments and in-hospital complications were centrally recorded using an internet-based standardized questionnaire.
  
  
  RESULTS
  Included were 6,330 patients from 243 hospitals, in group 1 (primary admission in 136 hospitals with cath lab) 4,656 patients (74%) and in group 2 (primary admission in 107 hospitals without cath lab) 1,674 (26%). Reperfusion therapy was performed more frequently in patients of group 1 (91.1% PCI, 2.7% fibrinolysis) than in group 2 (80.7% PCI after transfer, 6.4% fibrinolysis). In-hospital mortality was 7.3% in all patients, 7.0% in group 1 and 8.3% in group 2.
  
  
  CONCLUSIONS
  The DHR data show that about three quarters of patients with STEMI are primarily admitted to hospitals with cath labs. Primary PCI is the preferred treatment option both in hospitals with and without cath labs (in the latter after transfer); it is performed in about 85% of STEMI patients. In-hospital mortality is with over 7% higher in real-life than in randomized studies.
authors.affiliation: Herzzentrum Ludwigshafen, Medizinische Klinik B.
authors.forename: U
authors.initials: U
authors.lastname: Zeymer
authors.forename: R
authors.initials: R
authors.lastname: Hambrecht
authors.forename: H
authors.initials: H
authors.lastname: Theres
authors.forename: R
authors.initials: R
authors.lastname: Birkemeyer
authors.forename: A
authors.initials: A
authors.lastname: Gitt
authors.forename: S
authors.initials: S
authors.lastname: Schneider
authors.forename: J
authors.initials: J
authors.lastname: Senges
authors.forename: R
authors.initials: R
authors.lastname: Zahn
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000706:statistics & numerical data*; D006328:Cardiac Catheterization / Q000706:statistics & numerical data*; D015897:Comorbidity; D001026:Coronary Artery Bypass / Q000706:statistics & numerical data; D005260:Female; D005858:Germany; D006297:Health Services Accessibility; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality / Q000628:therapy*; D010043:Outcome and Process Assessment, Health Care; D012042:Registries; D011795:Surveys and Questionnaires; D015912:Thrombolytic Therapy / Q000706:statistics & numerical data; D014600:Utilization Review / Q000706:statistics & numerical data