2012
DOI: 10.1001/2012.jama.11348
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Association of Changes in Clinical Characteristics and Management With Improvement in Survival Among Patients With ST-Elevation Myocardial Infarction

Abstract: ContextThe contemporary decline in mortality reported in patients with STsegment elevation myocardial infarction (STEMI) has been attributed mainly to improved use of reperfusion therapy.Objective To determine potential factors-beyond reperfusion therapyassociated with improved survival in patients with STEMI over a 15-year period.

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Cited by 423 publications
(239 citation statements)
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References 20 publications
(34 reference statements)
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“…Furthermore, STEMI was over six times more frequently diagnosed than in Pauley et al's [6] study, whilst the NSTEMI rate was similar. Another point worth noting is that, for example, Ferrara et al [18] and Puymirat et al [19] demonstrated that a greater proportion of STEMI was found in women whilst our analysis showed a greater proportion in men. Not just the study of 210 patients with acute coronary syndrome [18], Figure 1.…”
Section: Discussioncontrasting
confidence: 40%
“…Furthermore, STEMI was over six times more frequently diagnosed than in Pauley et al's [6] study, whilst the NSTEMI rate was similar. Another point worth noting is that, for example, Ferrara et al [18] and Puymirat et al [19] demonstrated that a greater proportion of STEMI was found in women whilst our analysis showed a greater proportion in men. Not just the study of 210 patients with acute coronary syndrome [18], Figure 1.…”
Section: Discussioncontrasting
confidence: 40%
“…In this study, 30-day mortality occurred in 15 patients (3.6%), which is comparable with recent registry studies with primary PCI as the choice method of reperfusion [34]. Despite dramatically improved outcomes of AMI, which is a consequence of early reperfusion therapy, the prognosis of short-term patients is worse in STEMI compared with NSTEMI [35,36].…”
Section: Discussionsupporting
confidence: 84%
“…Significant reductions in mortality were noted between 1995 and 2015, largely attributed to reductions in time from symptom onset to first medical contact, greater use of reperfusion therapy, continuous multilead ST-segment monitoring, frequent measurement of vital signs and guideline recommended pharmacotherapy. 3 The goal of pharmacological anti-ischemic therapy is to decrease myocardial oxygen demand (secondary to a decrease in heart rate, blood pressure, preload or myocardial contractility) or to increase myocardial oxygen supply (by administration of oxygen or through coronary vasodilatation). If, following treatment, the patient does not rapidly become free of ischemic signs or symptoms, immediate coronary angiography is recommended independently of ECG findings and cardiac troponin levels.…”
Section: Pharmacotherapy Of Acsmentioning
confidence: 99%