Long-term trends in the use of coronary reperfusion strategies in acute myocardial infarction: a community-wide perspective
Authors
Goldberg, Robert J.Spencer, Frederick A.
Okolo, Joseph
Lessard, Darleen M.
Yarzebski, Jorge L.
Gore, Joel M.
UMass Chan Affiliations
Department of Medicine, Division of Cardiovascular MedicineDocument Type
Journal ArticlePublication Date
2007-06-23Keywords
Age DistributionAged
Aged, 80 and over
Angioplasty, Transluminal, Percutaneous Coronary
Female
Humans
Male
Massachusetts
Middle Aged
Myocardial Infarction
Myocardial Reperfusion
Residence Characteristics
Thrombolytic Therapy
Biostatistics
Cardiovascular Diseases
Epidemiology
Health Services Research
Metadata
Show full item recordAbstract
BACKGROUND: The objectives of our study were to examine long-term (1986-2003) trends in the use of percutaneous coronary interventions (PCI) and thrombolytic therapy in the management of patients hospitalized with acute myocardial infarction (AMI) while our secondary study goal was to examine factors associated with use of these coronary reperfusion strategies. While there have been considerable changes in the management of patients hospitalized with AMI over time, limited contemporary data are available about changing trends in the use of different coronary reperfusion strategies, particularly from the more generalizable perspective of a population-based investigation. METHODS: The study sample consisted of 9,422 greater Worcester (MA) residents hospitalized with confirmed AMI at all metropolitan Worcester medical centers in 10 annual periods between 1986 and 2003. RESULTS: Divergent trends in the use of PCI and thrombolytic therapy during hospitalization for AMI were noted. Use of thrombolytic therapy increased after its introduction to clinical practice in the mid-1980's through the early 1990's with a progressive decline in use thereafter. In 2003, 3.5% of patients hospitalized with AMI were treated with clot lysing therapy. On the other hand, marked increases in the use of PCI during hospitalization for AMI were noted over time. In 2003, 42.1% of patients with AMI received a PCI. Several demographic and clinical factors were associated with the use of these different treatment strategies. CONCLUSIONS: The results of our study in a large Northeast community suggest evolving changes in the hospital management of patients with AMI. Current management practices emphasize the utilization of PCI to restore coronary reperfusion to the infarct related artery.Source
J Thromb Thrombolysis. 2007 Jun;23(3):163-71. Link to article on publisher's siteDOI
10.1007/s11239-006-9029-0Permanent Link to this Item
http://hdl.handle.net/20.500.14038/47185PubMed ID
17186392Related Resources
Link to Article in PubMedae974a485f413a2113503eed53cd6c53
10.1007/s11239-006-9029-0