Baseline clinical characteristics and Patient profile of the TURKMI: First results of nation-wide acute myocardial infarction registry in Turkey

Erol, Mustafa Kemal; Kayıkçıoğlu, Meral; Kılıçkap, Mustafa; Arin, Can Baba; Kurt, Ibrahim Halil; Aktaş, İbrahim; Güneş, Yılmaz; Özkan, Eyüp; Sen, Taner Z.; İnce, Orhan; Örnek, Ender; Asoğlu, Ramazan; Aladağ, Nesim; Zeybey, Utku; Sinan, Ümit Yaşar; Dural, Muhammet; Doğan, Arda Can; Yenerçağ, Mustafa; Akboğa, Mehmet Kadri; Deveci, Onur Sinan; Somuncu, Mustafa Umut

doi:10.14744/anatoljcardiol.2020.69696

Cited by 11 publications

(17 citation statements)

References 23 publications

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“…The previous TURKMI study (clinicaltrials.gov NCT04241770) was also a 15-day registry (November 1-15, 2018) that prospectively enrolled patients with acute MI in Turkey ( 12 , 13 ). All consecutive patients admitted to the hospital within 48 hours of symptom-onset were registered in TURKMI-1.…”

Section: Methodsmentioning

confidence: 99%

Treatment Delays and In-Hospital Outcomes In Acute Myocardial Infarction During The Covid-19 Pandemic: A Nationwide Study

Erol¹

2020

Anatol J Cardiol

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Objective: Delayed admission of myocardial infarction (MI) patients is an important prognostic factor. In the present nationwide registry (TURKMI-2), we evaluated the treatment delays and outcomes of patients with acute MI during the Covid-19 pandemic and compaired with a recent pre-pandemic registry (TURKMI-1). Methods: The pandemic and pre-pandemic studies were conducted prospectively as 15-day snapshot registries in the same 48 centers. The inclusion criteria for both registries were aged ≥18 years and a final diagnosis of acute MI (AMI) with positive troponin levels. The only difference between the 2 registries was that the pre-pandemic (TURKMI-1) registry (n=1872) included only patients presenting within the first 48 hours after symptom-onset. TURKMI-2 enrolled all consecutive patients (n=1113) presenting with AMI during the pandemic period. Results: A comparison of the patients with acute MI presenting within the 48-hour of symptom-onset in the pre-pandemic and pandemic registries revealed an overall 47.1% decrease in acute MI admissions during the pandemic. Median time from symptom-onset to hospital-arrival increased from 150 min to 185 min in patients with ST elevation MI (STEMI) and 295 min to 419 min in patients presenting with non-STEMI (NSTEMI) (p-values <0.001). Door-to-balloon time was similar in the two periods (37 vs. 40 min, p=0.448). In the pandemic period, percutaneous coronary intervention (PCI) decreased, especially in the NSTEMI group (60.3% vs. 47.4% in NSTEMI, p<0.001; 94.8% vs. 91.1% in STEMI, p=0.013) but the decrease was not significant in STEMI patients admitted within 12 hours of symptom-onset (94.9% vs. 92.1%; p=0.075). In-hospital major adverse cardiac events (MACE) were significantly increased during the pandemic period [4.8% vs. 8.9%; p<0.001; age- and sex-adjusted Odds ratio (95% CI) 1.96 (1.20–3.22) for NSTEMI, p=0.007; and 2.08 (1.38–3.13) for STEMI, p<0.001]. Conclusion: The present comparison of 2 nationwide registries showed a significant delay in treatment of patients presenting with acute MI during the COVID-19 pandemic. Although PCI was performed in a timely fashion, an increase in treatment delay might be responsible for the increased risk of MACE. Public education and establishing COVID-free hospitals are necessary to overcome patients’ fear of using healthcare services and mitigate the potential complications of AMI during the pandemic.

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Section: Methodsmentioning

confidence: 99%

Treatment Delays and In-Hospital Outcomes In Acute Myocardial Infarction During The Covid-19 Pandemic: A Nationwide Study

Erol¹

2020

Anatol J Cardiol

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“…The methods and baseline characteristics of the TURKMI registry (clinicaltrials.gov, NCT04241770) were published in detail elsewhere. 2,3 Briefly, this is a nationwide, multicenter registry enrolling patients with troponin positive acute coronary syndrome. The protocol has been approved by a local ethics committee (University of Health Sciences, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, No: 2018-46) and complies with the Declaration of Helsinki.…”

Section: Methodsmentioning

confidence: 99%

“…We conducted the Turkish Myocardial Infarction (TURKMI) registry to obtain this information so that we could apply effective strategies to reduce the morbidity and mortality associated with acute MI. 2,3 Recent findings of this registry demonstrated that treatment guidelines were largely implemented. 3 Herein, we present the periprocedural and in-hospital outcomes as well as 30-day and 1-year mortality.…”

Section: Introductionmentioning

confidence: 99%

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Short and Midterm Outcomes in Patients With Acute Myocardial Infarction: Results of the Nationwide TURKMI Registry

et al. 2020

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This recent Turkish Myocardial Infarction registry reported that guidelines are largely implemented in patients with acute myocardial infarction (MI) in Turkey. We aimed to obtain up-to-date information for short- and midterm outcomes of acute MI. Fifty centers were selected using probability sampling, and all consecutive patients with acute MI admitted to these centers (between November 1 and 16, 2018) were enrolled. Among 1930 (mean age 62 ± 13 years, 26% female) patients, 1195 (62%) had non-ST segment elevation myocardial infarction (NSTEMI) and 735 (38%) had ST segment elevation myocardial infarction (STEMI). Percutaneous coronary intervention (PCI) was performed in 94.4% of patients with STEMI and 60.2% of those with NSTEMI. Periprocedural mortality occurred in 4 (0.3%) patients. In-hospital mortality was significantly higher in STEMI than in patients with NSTEMI (5.4% vs 2.9%, respectively; P = .006). However, the risk became slightly higher in the NSTEMI group at 1 year. Women with STEMI had a significantly higher in-hospital mortality compared with men (11.2% vs 3.8%; P < .001); this persisted at follow-up. In conclusion, PCI is performed in Turkey with a low risk of complications in patients with acute MI. Compared with a previous registry, in-hospital mortality decreased by 50% within 20 years; however, the risk remains too high for women with STEMI.

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“…) is a 15-day snapshot registry that enrolled all consecutive patients with acute MI in Turkey. The rationale and design of the TURKMI registry have been described in detail previously (5,6). All the patients were prospectively enrolled between November 01 and November 15, 2018, from 50 cardiology clinics representing the 12 Eurostat-Nuts Statistical Regions of Turkey proportional to Turkey's 2018 census (7).…”

Section: Turkmi (Clinicaltrialsgov Nct04241770mentioning

confidence: 99%

Time delays in each step from symptom onset to treatment in acute myocardial infarction: Results from a nation-wide TURKMI registry

Erol

Kayıkçıoğlu

Kılıçkap

et al. 2021

Anatolian J Cardiol

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Objective: In this study, we aimed to analyze the TURKMI registry to identify the factors associated with delays from symptom onset to treatment that would be the focus of improvement efforts in patients with acute myocardial infarction (AMI) in Turkey. Methods: The TURKMI study is a nation-wide registry that was conducted in 50 centers capable of 24/7 primary percutaneous coronary intervention (PCI). All consecutive patients (n=1930) with AMI admitted to coronary care units within 48 hours of symptom onset were prospectively enrolled during a predefined 2-week period between November 1, 2018, and November 16, 2018. All the patients were examined in detail with regard to the time elapsed at each step from symptom onset to initiation of treatment, including door-to-balloon time (D2B) and total ischemic time (TIT). Results: After excluding patients who suffered an AMI within the hospital (2.6%), the analysis was conducted for 1879 patients. Most of the patients (49.5%) arrived by self-transport, 11.8% by emergency medical service (EMS) ambulance, and 38.6% were transferred from another EMS without PCI capability. The median time delay from symptom-onset to EMS call was 52.5 (15-180) min and from EMS call to EMS arrival 15 (10-20) min. In ST-segment elevation myocardial infarction (STEMI), the median D2B time was 36.5 (25-63) min, and median min. TIT was significantly prolonged from 151 (90-285) min to 250 (165-372) min in patients transferred from non-PCI centers. The major significant factors associated with time delay were patient-related delay and the mode of hospital arrival, both in STEMI and non-STEMI. Conclusion:The baseline evaluation of the TURKMI study revealed that an important proportion of patients presenting with AMI within 48 hours of symptom onset reach the PCI treatment center later than the time proposed in the guidelines, and the use of EMS for admission to hospital is extremely low in Turkey. Patient-related factors and the mode of hospital admission were the major factors associated with the time delay to treatment.

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Baseline clinical characteristics and Patient profile of the TURKMI: First results of nation-wide acute myocardial infarction registry in Turkey

Cited by 11 publications

References 23 publications

Treatment Delays and In-Hospital Outcomes In Acute Myocardial Infarction During The Covid-19 Pandemic: A Nationwide Study

Treatment Delays and In-Hospital Outcomes In Acute Myocardial Infarction During The Covid-19 Pandemic: A Nationwide Study

Short and Midterm Outcomes in Patients With Acute Myocardial Infarction: Results of the Nationwide TURKMI Registry

Time delays in each step from symptom onset to treatment in acute myocardial infarction: Results from a nation-wide TURKMI registry

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