Comparative analysis between 2 periods of acute myocardial infarction after a decade in Mallorca. IBERIA Study (996-1998) and Infarction-Code (2008-2010).
OBJECTIVE
To investigate the differences in mortality at 28 days and other prognostic variables in 2 periods: IBERICA-Mallorca (1996-1998) and Infarction Code of the Balearic Islands (IC-IB) (2008-2010).


METHODS
Two observational prospective cohorts.


METHODS
Hospital Universitario Son Dureta, 1996-1998 and 2008-2010.


METHODS
Acute coronary syndrome with ST elevation of≤24h of anterior and inferior site.


METHODS
Age, sex, cardiovascular risk factors, site of AMI, time delays, reperfusion therapy with fibrinolysis and primary angioplasty, administration of acetylsalicylic acid, beta blockers and angiotensin converting enzyme inhibitors. Killip class, malignant arrhythmias, mechanical complications and death at 28 days were included.


RESULTS
Four hundred and forty-two of the 889 patients included in the IBERICA-Mallorca and 498 of 847 in the IC-IB were analyzed. The site and Killip class on admission were similar in both cohorts. The main significant difference between IBERICA and IC-IB group were age (64 vs. 58 years), prior myocardial infarction (17.9 vs. 8.1%), the median symtoms to first ECG time (120 vs. 90min), median first ECG to fibrinolysis time (60 vs. 35min), fibrinolytic therapy (54.8 vs. 18.7%), patients without revascularization treatment (45.9 vs. 9.2%), primary angioplasty (1.0% vs. 92.0%). The mortality at 28 days was lower in the IC-IB (12.2 vs. 7.2%; hazard ratio 0.560; 95% CI 0.360-0.872; P=.010).


CONCLUSIONS
The 28-day mortality in acute coronary syndrome with ST elevation in Mallorca has declined in the last decade, basically due to increased reperfusion therapy with primary angioplasty and reducing delays time to reperfusion.
Servicio de Medicina Intensiva, Hospital Son Llàtzer, Palma de Mallorca, España. Electronic address: lsocias@hsll.es.
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Socias
Instituto de Investigación Sanitaria de Palma (IdISPa), Hospital Universitario Son Espases, Palma de Mallorca, España.
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Frontera
Servicio de Medicina Intensiva, Hospital Son Llàtzer, Palma de Mallorca, España.
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Rubert
Servicio de Medicina Intensiva, Hospital Universitario Son Espases, Palma de Mallorca, España.
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Carrillo
Servicio de Cardiología, Hospital Universitario Son Espases, Palma de Mallorca, España.
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Peral
Servicio de Medicina Intensiva, Hospital Universitario Son Espases, Palma de Mallorca, España.
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Rodriguez
Servicio de Medicina Intensiva, Hospital Universitario Son Espases, Palma de Mallorca, España.
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Royo
Servicio de Medicina Intensiva, Hospital Universitario Son Espases, Palma de Mallorca, España.
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Ferreruela
Servicio de Cardiología, Hospital Son Llàtzer, Palma de Mallorca, España.
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Torres
IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, España.
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Elosua
Servicio de Cardiología, Hospital Universitario Son Espases, Palma de Mallorca, España.
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Bethencourt
Instituto de Investigación Sanitaria de Palma (IdISPa), Hospital Universitario Son Espases, Palma de Mallorca, España.
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Fiol
D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality*; D011446:Prospective Studies; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D016896:Treatment Outcome
Acute coronary syndrome with ST elevation; Acute myocardial infarction; Care program; Código Infarto; Infarction Code; Infarto agudo de miocardio; Mortalidad; Mortality; Programa asistencial; Síndrome coronario agudo con elevación de ST