German nationwide data on current trends and management of acute myocardial infarction: discrepancies between trials and real-life

Freisinger, Eva; Fuerstenberg, Torsten; Malyar, Nasser; Wellmann, Juergen; Keil, Ulrich; Breithardt, G; Reinecke, Holger

doi:10.1093/eurheartj/ehu043

Cited by 101 publications

(87 citation statements)

References 48 publications

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“…The database included the entirety of hospitalized cases with AMI (within 28 days of onset of symptoms; ICD I21 -I22) in Germany of the years 2005, 2007, and 2009 as previously described in detail [1]. Of these, cases with encoded secondary diagnosis of PAD (ICD I70.2*) and endstage PAD (PAD Fontaine stage IV; ICD I70.…”

Section: Codingmentioning

confidence: 99%

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Peripheral artery disease is associated with high in-hospital mortality particularly in males with acute myocardial infarction in a nationwide real-world setting

Freisinger

Malyar

Reinecke

2016

Vasa

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Summary:Background: Patients with peripheral arterial disease (PAD) are at high risk for cardiovascular morbidity and mortality. The objective of this nationwide analysis was to explore the association of PAD with in-hospital mortality in patients hospitalized for acute myocardial infarction (AMI). Patients and methods: Data on all in-patient hospitalizations in Germany are continuously transferred to the Federal Statistical Offi ce (DESTATIS), as required by federal law. These case-based data on AMI in the years 2005, 2007 and 2009 were analyzed regarding ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation myocardial infarction (NSTEMI) as the primary diagnoses and concomitant PAD as the secondary diagnosis with respect to age and gender related disparity. Results: We analyzed 619,103 AMI cases, including 270,026 (43.6 %) with STEMI and 349,077 (56.4 %) with NSTEMI. The PAD ratio was 3.4 % in STEMI and 5.7 % in NSTEMI. In STEMI, in-hospital mortality was 15.6 % in cases with PAD vs. 12.0 % without, and 12.0 % vs. 9.8 % in NSTEMI, respectively (P < 0.001; 2009). Although female gender was associated with a signifi cantly higher in-hospital mortality, the presence of PAD particularly negatively affected in-hospital mortality in men (+ 60 % male vs -11 % female in STEMI; + 33 % male vs -3 % female in NSTEMI). Conclusions: Our data demonstrate the adverse impact of concomitant PAD on in-hospital mortality in AMI, in a large-scale, real-world scenario. Further research, particularly with a focus on gender, is needed to identify diagnostic and therapeutic measures to reduce the remarkably high in-hospital mortality of AMI patients with concomitant PAD.

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Section: Codingmentioning

confidence: 99%

“…In a real-life setting, acute myocardial infarction (AMI) has recently been reported to have an in-hospital mortality of 10.8 % in Germany [1], highlighting the persistent severity of this medical burden combined with the need for improved diagnostics and therapy.…”

Section: Introductionmentioning

confidence: 99%

Peripheral artery disease is associated with high in-hospital mortality particularly in males with acute myocardial infarction in a nationwide real-world setting

Freisinger

Malyar

Reinecke

2016

Vasa

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“…Поэтому общую летальность можно предполагать более высокую. По данным националь-ного регистра ФРГ, госпитальная летальность больных ИМпST в 2005, 2007 и 2009гг составила 11,2%, 11,9% и 12,2%, соответственно [17]. Согласно национальным регистрам инфаркта миокарда в Швеции и Велико-британии средняя 30-дневная летальность в 2004-2010гг в этих странах составила 7,6% и 10,5%, соответ-ственно [18].…”

Section: оригинальные статьиunclassified

Coronary Reperfusion in St Elevation Myocardial Infarction: Problems and Solutions

Марков¹,

Вышлов²,

Карпов³

2015

Russ J Cardiol

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The article analyzes a comparative efficacy of pharmacoinvasive reperfusion and primary percutaneous intervention in patients with ST elevation acute myocardial infarction in real clinical practice with fulfillment of Guidelines for the "first-medicalcontact -balloon time". The problem of choice is underlined on the most effective reperfusion method by emergency teams. The data is provided on a novel medication -non-immunogenic staphylokinase made in Russia (Fortelyzin ® ). The detailed analysis has been done on hospital mortality in myocardial infarction in Russian and abroad hospitals. Russ J Cardiol CORONARY REPERFUSION IN ST ELEVATION MYOCARDIAL INFARCTION: PROBLEMS AND SOLUTIONSMarkov V. A. В статье приводится анализ сравнительной эффективности фармакоинвазив-ной реперфузии и первичного чрескожного вмешательства у больных острым инфарктом миокарда с подъемом сегмента ST в реальной клинической прак-тике и выполнения клинических рекомендаций по времени -первый медицин-ский контакт-баллон. Акцент сделан на проблемах выбора наиболее эффектив-ного метода реперфузии бригадами скорой медицинской помощи. Представ-лена информация о новом препарате -неиммуногенной отечественной стафилокиназе (Фортелизин ® ). Проведен сравнительный анализ госпитальной летальности при инфаркте миокарда в зарубежных и отечественных клиниках.Российский кардиологический журнал 2015, 1 (117): 53-58 http://dx

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“…Fees are adjusted yearly based on expenditure data from a sample group of German hospitals and are subject to continuous calibration to accurately reimburse cost [9][10][11][12][13][14]. These databases represent a valuable source of national-level health economic data that has been used previously to examine other disorders [15,16]. The data is highly detailed and includes a wide range of patient characteristics and preexisting conditions, which we have included in our analysis.…”

Section: Introductionmentioning

confidence: 99%

The impact of post-procedural complications on reimbursement, length of stay and mechanical ventilation among patients undergoing transcatheter aortic valve implantation in Germany

et al. 2017

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German nationwide data on current trends and management of acute myocardial infarction: discrepancies between trials and real-life

Abstract: This hospitalization-based analysis revealed a marked increase of NSTEMI among constant AMI frequency. Despite all current efforts, in-hospital mortality was stagnating on a high level compared with data of RCTs.

Cited by 101 publications

References 48 publications

Peripheral artery disease is associated with high in-hospital mortality particularly in males with acute myocardial infarction in a nationwide real-world setting

Peripheral artery disease is associated with high in-hospital mortality particularly in males with acute myocardial infarction in a nationwide real-world setting

Coronary Reperfusion in St Elevation Myocardial Infarction: Problems and Solutions

The impact of post-procedural complications on reimbursement, length of stay and mechanical ventilation among patients undergoing transcatheter aortic valve implantation in Germany

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