Management of Acute Myocardial Infarction in Intensive Care Units in 1995: A Nationwide French Survey of Practice and Early Hospital Results

Danchin, Nicolás; Vaur, L; Genès, N; Renault, Maguy; Ferrières, Jean; Etienne, Sylvie; Cambou, Jean-Pierre

doi:10.1016/s0735-1097(97)00371-9

Cited by 111 publications

(57 citation statements)

References 31 publications

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“…Five nationwide French registries were conducted 5 years apart over a 20-year period : USIK 1995, 13 USIC (Unité de Soins Intensifs Coronaires) 2000, 14 FAST-MI (French Registry of Acute ST-Elevation or non-ST-elevation Myocardial Infarction) 2005 (NCT00673036), 15 FAST-MI 2010 (NCT01237418), 16 and FAST-MI 2015 (NCT02566200) 17 (Methods I in the online-only Data Supplement). The methods used for these registries have been detailed previously .…”

Section: Patient Populationmentioning

confidence: 99%

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Acute Myocardial Infarction

et al. 2017

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BACKGROUND: ST-segment-elevation myocardial infarction (STEMI) and non-ST-segment-elevation myocardial infarction (NSTEMI) management has evolved considerably over the past 2 decades. Little information on mortality trends in the most recent years is available. We assessed trends in characteristics, treatments, and outcomes for acute myocardial infarction in France between 1995 and 2015. METHODS:We used data from 5 one-month registries, conducted 5 years apart, from 1995 to 2015, including 14 423 patients with acute myocardial infarction (59% STEMI) admitted to cardiac intensive care units in metropolitan France. RESULTS:From 1995 to 2015, mean age decreased from 66±14 to 63±14 years in patients with STEMI; it remained stable (68±14 years) in patients with NSTEMI, whereas diabetes mellitus, obesity, and hypertension increased. At the acute stage, intended primary percutaneous coronary intervention increased from 12% (1995) to 76% (2015) in patients with STEMI. In patients with NSTEMI, percutaneous coronary intervention ≤72 hours from admission increased from 9% (1995) to 60% (2015). Six-month mortality consistently decreased in patients with STEMI from 17.2% in 1995 to 6.9% in 2010 and 5.3% in 2015; it decreased from 17.2% to 6.9% in 2010 and 6.3% in 2015 in patients with NSTEMI. Mortality still decreased after 2010 in patients with STEMI without reperfusion therapy, whereas no further mortality gain was found in patients with STEMI with reperfusion therapy or in patients with NSTEMI, whether or not they were treated with percutaneous coronary intervention. CONCLUSIONS:Over the past 20 years, 6-month mortality after acute myocardial infarction has decreased considerably for patients with STEMI and NSTEMI. Mortality figures continued to decline in patients with STEMI until 2015, whereas mortality in patients with NSTEMI appears stable since 2010. ORIGINAL RESEARCH ARTICLE T he early outcome of patients with acute myocardial infarction (AMI) has improved considerably. Acute Myocardial Infarction1-6 Among patients with AMI, however, the pathophysiology, management, and outcomes differ between those with ST-segment-elevation myocardial infarction (STEMI) and non-ST-segment-elevation myocardial infarction (NSTEMI). Traditionally, patients with NSTEMI have a substantially lower early mortality than those with STEMI, but a higher risk of long-term mortality, likely explained by more frequent risk factors and comorbidities, and a greater burden of coronary artery disease. 7-9The improvement in early outcomes up to the early 2010s has been attributed to changes in patient populations, more frequent use of revascularization procedures, and increased use of recommended medications. 5,6,[10][11][12] Since 2010, however, little information is available on early outcomes in real-world settings, although the use of percutaneous coronary interventions (PCIs) has continued to increase and newer antithrombotic agents have become available and are now widely used. Whether these changes in the most recent years have translated ...

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Section: Patient Populationmentioning

confidence: 99%

“…The methods used for these registries have been detailed previously . [13][14][15][16][17] In brief, their primary objectives were to evaluate the characteristics, management, and outcomes of patients with AMI, as seen in routine clinical practice, on a countrywide scale.…”

Section: Patient Populationmentioning

confidence: 99%

Acute Myocardial Infarction

et al. 2017

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“…5,8,14,15 These factors have included age, extent of left ventricular dysfunction, infarct size, and development of heart failure. [41][42][43][44] It is notable that most of these factors result in sympathetic activation, 1,2,13 which in turn is believed to lead to an adverse outcome.…”

Section: Graham Et Al Sympathetic Drive and Site Of Infarctionmentioning

confidence: 99%

“…Adverse prognosis after AMI has been associated with factors such as advanced age, larger infarcts, and left ventricular systolic dysfunction, [5][6][7][8][9][10][11][12] conditions in which a disproportionate sympathetic activation is known to occur. 1,2,13 However, although the prognosis after ant-AMI is poorer than after inf-AMI, 5,8,14,15 it is as yet unknown whether sympathetic nerve hyperactivity occurs to a greater extent in the former than the latter.…”

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Sympathetic Drive in Anterior and Inferior Uncomplicated Acute Myocardial Infarction

et al. 2004

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Background-The sympathetic activation that follows acute myocardial infarction (AMI) has been associated with increased morbidity and mortality. Because the prognosis after anterior AMI (ant-AMI) is worse than that after inferior AMI (inf-AMI), we planned to determine whether the magnitude of sympathetic hyperactivity differs between the two. Methods and Results-Thirty-nine patients with uncomplicated AMI, comprising 2 matched groups of 17 patients with ant-AMI, and 22 patients with inf-AMI were examined. Measurements were obtained 2 to 4 days after AMI and compared with 20 normal subjects (NC) who were matched in terms of age and body weight to the AMI groups. Resting muscle sympathetic nerve activity was quantified from multiunit bursts (MSNA) and from single units (s-MSNA). Both groups of AMI patients were matched with regard to hemodynamic variables, left ventricular function, and infarct size. Both groups had greater (at least PϽ0.01) sympathetic nerve activity than NC (60Ϯ4.3 bursts/100 cardiac beats and 68Ϯ4.9 impulses/100 cardiac beats), but the magnitude of sympathetic nerve hyperactivity in ant-AMI (81Ϯ4.0 bursts/100 cardiac beats and 91Ϯ4.9 impulses/100 cardiac beats) was similar (PϾ0.05) to that in inf-AMI (80Ϯ3.2 bursts/100 cardiac beats and 90Ϯ4.0 impulses/100 cardiac beats) Conclusions-Both ant-AMI and inf-AMI resulted primarily in a similar magnitude of sympathetic nerve hyperactivity.These findings suggest that the worse prognosis after ant-AMI compared with after inf-AMI would not be related primarily to the degree of sympathetic hyperactivity.

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