Prognosis and management of myocardial infarction: Comparisons between the French FAST-MI 2010 registry and the French public health database.
BACKGROUND
Multicentre registries of myocardial infarction management show a steady improvement in prognosis and greater access to myocardial revascularization in a more timely manner. While French registries are the standard references, the question arises: are data stemming solely from the activity of French cardiac intensive care units (ICUs) a true reflection of the entire French population with ST-segment elevation myocardial infarction (STEMI)?


OBJECTIVE
To compare data on patients hospitalized for STEMI from two French registries: the French registry of acute ST-elevation or non-ST-elevation myocardial infarction (FAST-MI) and the Échantillon généraliste des bénéficiaires (EGB) database.


METHODS
We compared patients treated for STEMI listed in the FAST-MI 2010 registry (n=1716) with those listed in the EGB database, which comprises a sample of 1/97th of the French population, also from 2010 (n=403).


RESULTS
Compared with the FAST-MI 2010 registry, the EGB database population were older (67.2±15.3 vs 63.3±14.5 years; P<0.001), had a higher percentage of women (36.0% vs 24.7%; P<0.001), were less likely to undergo emergency coronary angiography (75.2% vs 96.3%; P<0.001) and were less often treated in university hospitals (27.1% vs 37.0%; P=0.001). There were no significant differences between the two registries in terms of cardiovascular risk factors, comorbidities and drug treatment at admission. Thirty-day mortality was higher in the EGB database (10.2% vs 4.4%; P<0.001).


CONCLUSIONS
Registries such as FAST-MI are indispensable, not only for assessing epidemiological changes over time, but also for evaluating the prognostic effect of modern STEMI management. Meanwhile, exploitation of data from general databases, such as EGB, provides additional relevant information, as they include a broader population not routinely admitted to cardiac ICUs.
UMR 6284, cardiovascular interventional therapy and imaging (CaVITI), image science for interventional techniques (ISIT), université de Clermont, université d'Auvergne, 63000 Clermont-Ferrand, France; Cardiology department, Clermont university hospital, 58, rue Montalembert, 63000 Clermont-Ferrand, France.
Grégoire
G
Massoullié
UMR 6284, cardiovascular interventional therapy and imaging (CaVITI), image science for interventional techniques (ISIT), université de Clermont, université d'Auvergne, 63000 Clermont-Ferrand, France; Cardiology department, Clermont university hospital, 58, rue Montalembert, 63000 Clermont-Ferrand, France.
Jérome
J
Wintzer-Wehekind
Pharmacology department, CHU of Clermont-Ferrand, 63000 Clermont-Ferrand, France.
Chouki
C
Chenaf
Biostatistics unit, clinical research and innovation delegation, CHU of Clermont-Ferrand, 63000 Clermont-Ferrand, France.
Aurélien
A
Mulliez
Biostatistics unit, clinical research and innovation delegation, CHU of Clermont-Ferrand, 63000 Clermont-Ferrand, France.
Bruno
B
Pereira
Pharmacology department, CHU of Clermont-Ferrand, 63000 Clermont-Ferrand, France.
Nicolas
N
Authier
Pharmacology department, CHU of Clermont-Ferrand, 63000 Clermont-Ferrand, France.
Alain
A
Eschalier
UMR 6284, cardiovascular interventional therapy and imaging (CaVITI), image science for interventional techniques (ISIT), université de Clermont, université d'Auvergne, 63000 Clermont-Ferrand, France; Cardiology department, Clermont university hospital, 58, rue Montalembert, 63000 Clermont-Ferrand, France.
Guillaume
G
Clerfond
UMR 6284, cardiovascular interventional therapy and imaging (CaVITI), image science for interventional techniques (ISIT), université de Clermont, université d'Auvergne, 63000 Clermont-Ferrand, France; Cardiology department, Clermont university hospital, 58, rue Montalembert, 63000 Clermont-Ferrand, France.
Géraud
G
Souteyrand
Inserm, U-698, UPMC-Paris 6, clinical research unit (URC)-Est, hospital Saint-Antoine, AP-HP, 75012 Paris, France.
Simon
S
Tabassome
Inserm U-970, department of cardiology, European hospital of Georges-Pompidou, university Paris Descartes, AP-HP, 75015 Paris, France.
Nicolas
N
Danchin
UMR 6284, cardiovascular interventional therapy and imaging (CaVITI), image science for interventional techniques (ISIT), université de Clermont, université d'Auvergne, 63000 Clermont-Ferrand, France; Cardiology department, Clermont university hospital, 58, rue Montalembert, 63000 Clermont-Ferrand, France.
Bernard
B
Citron
UMR 6284, cardiovascular interventional therapy and imaging (CaVITI), image science for interventional techniques (ISIT), université de Clermont, université d'Auvergne, 63000 Clermont-Ferrand, France; Cardiology department, Clermont university hospital, 58, rue Montalembert, 63000 Clermont-Ferrand, France.
Jean-René
JR
Lusson
Inserm U-970, department of cardiology, European hospital of Georges-Pompidou, university Paris Descartes, AP-HP, 75015 Paris, France.
Étienne
É
Puymirat
UMR 6284, cardiovascular interventional therapy and imaging (CaVITI), image science for interventional techniques (ISIT), université de Clermont, université d'Auvergne, 63000 Clermont-Ferrand, France; Cardiology department, Clermont university hospital, 58, rue Montalembert, 63000 Clermont-Ferrand, France.
Pascal
P
Motreff
UMR 6284, cardiovascular interventional therapy and imaging (CaVITI), image science for interventional techniques (ISIT), université de Clermont, université d'Auvergne, 63000 Clermont-Ferrand, France; Cardiology department, Clermont university hospital, 58, rue Montalembert, 63000 Clermont-Ferrand, France. Electronic address: reschalier@chu-clermontferrand.fr.
Romain
R
Eschalier
D017023:Coronary Angiography; D019468:Disease Management; D005260:Female; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D015994:Incidence; D008297:Male; D009203:Myocardial Infarction / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D011159:Population Surveillance; D011379:Prognosis; D011634:Public Health; D012042:Registries; D012189:Retrospective Studies; D013997:Time Factors
Epidemiology; Management; Prise en charge; Prognosis; Pronostique; STEMI; Therapeutics; Thérapeutique; Épidémiologie