PTCA registry of German community hospitals

Vogt, A.; Bonzel, T.; Harmjanz, D; Leitner, Eva; Pfafferott, C.; Engel, H.-J.; Niederer, W.; Schuster, Paul; Glunz, Hans-Georg; Neuhaus, Karl-Ludwig

doi:10.1093/oxfordjournals.eurheartj.a015405

Cited by 54 publications

(7 citation statements)

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“…Details of the organization of the registry have been published previously. 11 In brief all interventions were prospectively enrolled in the registry by telephone or fax to the coordinating centre in Kassel. All complications occurring in the catheter room and during the in-hospital phase were prospectively documented.…”

Section: Structure Of the Alkk Registrymentioning

confidence: 99%

Predictors of in-hospital mortality in 1333 patients with acute myocardial infarction complicated by cardiogenic shock treated with primary percutaneous coronary intervention (PCI) Results of the primary PCI registry of the Arbeitsgemeinschaft Leitende Kardiologische Krankenhausärzte (ALKK)

Zeymer

Vogt²,

Zahn³

et al. 2004

European Heart Journal

223

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Aims Acute myocardial infarction complicated by cardiogenic shock is associated with an exceedingly high mortality, even if patients are treated with early reperfusion therapy. The aim of this study was to evaluate predictors of in-hospital mortality of a large cohort of consecutive patients with cardiogenic shock treated with primary percutaneous coronary intervention (PCI). Methods and results Between July 1994 and March 2001 all interventions performed in 80 centres in Germany were prospectively entered into the primary PCI registry of the ALKK. A total of 9422 procedures were registered, of these 1333 (14.2%) were performed in patients with cardiogenic shock. Total in-hospital mortality was 46.1% and was dependent on TIMI flow grade after PCI, with mortality rates of 78.2%, 66.1% and 37.4% in patients with TIMI 0/1, TIMI 2 and TIMI 3 flow, respectively. In a multivariate analysis left main disease, TIMI <3 flow after PCI, older age, three-vessel disease and longer time-intervals between symptom onset and PCI were significant independent predictors of mortality. The relative number of PCIs performed in patients with cardiogenic shock did not change significantly from 1995-2000. There was a significant decrease in mortality over the years (P for trend 0.02). Conclusions In-hospital mortality in patients with acute myocardial infarction complicated by cardiogenic shock remains high, even with early interventional therapy. However, our data demonstrate that the PCI in these high-risk patients is feasible in a wide spectrum of community hospitals with acceptable success rates. Our results seen in connection with the results of the randomized SHOCK study advocate an early invasive approach in younger patients with cardiogenic shock, while the best strategy in elderly patients is still a matter of debate.

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Section: Structure Of the Alkk Registrymentioning

confidence: 99%

Predictors of in-hospital mortality in 1333 patients with acute myocardial infarction complicated by cardiogenic shock treated with primary percutaneous coronary intervention (PCI) Results of the primary PCI registry of the Arbeitsgemeinschaft Leitende Kardiologische Krankenhausärzte (ALKK)

Zeymer

Vogt²,

Zahn³

et al. 2004

European Heart Journal

223

View full text Add to dashboard Cite

show abstract

“…2 3 The German Community Hospitals series from 1992-94 had 98% follow up, however this pre-dates widespread stenting, with a stent rate of only 2.8%. 4 The European registry of cardiac catheter interventions from 1996 concerns activity rather than outcomes. 5 The OPEN registry attempted to overcome these limitations by using a very large number of national centres, recruiting all patients, and having fully audited one month follow up.…”

Section: Discussionmentioning

confidence: 99%

Aortic tornado

Babu‐Narayan

2005

Heart

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“…Several groups have previously published their experience with PCI without on-site surgical back-up (6,8,9,22,23). The early studies (1990 to 1992) had small numbers of patients and do not reflect current PCI management.…”

Section: Discussionmentioning

confidence: 99%