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  • 1 Department of Cardiology, Zala County Hospital, Zalaegerszeg, Hungary
  • 2 Western Transdanubian Regional Institute, Hungarian National Public Health and Medical Officer Service, Győr, Hungary
  • 3 Western Transdanubian Regional Institute, Hungarian National Public Health and Medical Officer Service, Zalaegerszeg, Hungary
  • 4 Department of Cardiology, Hospital of Zala County, Zrinyi M. str. 1, H-8900 Zalaegerszeg, Hungary
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Abstract

Introduction

Morbidity and mortality data of acute myocardial infarction highlight the significance of this patient population worldwide. Rapid and accurate diagnosis and timely initiation of an appropriate therapy are of crucial importance in this group of patients. Invasive cardiology, i.e. primary percutaneous coronary intervention is already a basic requirement of up-to-date medical care for acute myocardial infarction. However, American and European guidelines of 1999 positioned primary percutaneous coronary intervention as Class I recommendation, only as an alternative to thrombolysis and for the treatment of patients with a complicated cardiogenic shock. In Hungary, we organized a 24 h intervention service for acute myocardial infarction at the Department of Cardiology in the Zala County Hospital, Zalaegerszeg for the first time in 1998.

Objectives

Our study was aimed at demonstrating that the timely intervention therapy of acute myocardial infarction reduced the mortality rate of the disease in our region to a more significant extent as compared to the national average, and the effects of this can be experienced even now.

Methods

The Western Transdanubian Regional Institute of the Hungarian National Public Health and Medical Officer Service (ÁNTSZ) processed the mortality data of the period between 1997 and 2005 in the Western Transdanubian Region and in the Zalaegerszeg area, and compared them with each other and with the national average published by the Hungarian Central Statistical Office. With the help of our own computerised data base, we studied the changes in the number of invasive interventions during this period, and correlated them with mortality statistics.

Results

During the first “complete” year, in 1998, we performed 82 primary and 283 “elective” primary percutaneous coronary interventions; by 2005 these numbers increased to 318 and 1,265, respectively. In parallel with this, early and total mortality rate due to myocardial infarction among male patients decreased in the Zalaegerszeg area to a significantly (p < 0.001) greater extent than the national average.

Conclusion

Our 24-h intervention care for acute infarction, launched as the first of its kind in Hungary, improved mortality statistics in the area to a significant degree as compared to the national average. The results of these experiments by the team, which has gained considerable experience, represent an advantage for the patients of the Zalaegerszeg area.

  • [1] Ryan, T. J., Antman, E. M., Brooks, N. H. et al. 1999 1999 update: ACC/AHA guidelines for the management of patients with acute myocardial infarction: executive summary and recommendations: a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines (Committee on Management of Acute Myocardial Infarction) Circulation 100 10161030.

    • Search Google Scholar
    • Export Citation
  • [2] Araujo Goncalves De, P., Ferreira, J., Aquiiar, C. et al. 2005 TIMI, PURSUIT and GRACE risk scores: sustained prognostic value and interaction with revascularization Eur. Heart J. 26 865872.

    • Search Google Scholar
    • Export Citation
  • [3] Avezum, A., Makdisse, M., Spencer, F. et al. 2005 Impact of age on management and outcome of acute coronary syndrome: observations from the Global Registry of Acute Coronary Events (GRACE) Am. Heart J. 149 6773.

    • Search Google Scholar
    • Export Citation
  • [4] Terkelsen, C., Lassen, J., Norgaard, B. et al. 2005 Mortality rates in patients with ST elevation vs. non-ST elevation acute myocardial infarction: observations from an unselected cohort Eur. Heart J. 26 1826.

    • Search Google Scholar
    • Export Citation
  • [5] Julian, D. G., Boissel, J. F., Bono De, D. P. et al. 1996 Acute myocardial infarction: pre-hospital and in-hospital management. The Task Force on the Management of Acute Myocardial Infarction of the European Society of Cardiology Eur. Heart J. 17 4363.

    • Search Google Scholar
    • Export Citation
  • [6] Werf Van der, F., Ardissino, D., Betriu, A. et al. 2003 Management of acute myocardial infarction in patients presenting with ST segment elevation Eur. Heart J. 24 2866.

    • Search Google Scholar
    • Export Citation
  • [7] Antman, E. M., Hand, M., Armstrong, P. W. et al. 2008 2007 focused update of the ACC/AHA 2004 guidelines for the management of patients with ST-elevation myocardial infarction. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines Circulation 117 296329.

    • Search Google Scholar
    • Export Citation
  • [8] Werf Van de, F., Bax, J., Betriu, A. et al. 2008 Management of acute myocardial infarction in patients presenting with persistent ST-segment elevation: the Task Force on the Management of ST-Segment Elevation Acute Myocardial Infarction of the European Society of Cardiology Eur. Heart J. 29 29092945.

    • Search Google Scholar
    • Export Citation
  • [9] European Health for All Database, WHO/Europe, 2007. http://www.euro.who.int.

  • [10] V. Hajdú, P., Ádány, R. (eds.) 2003 Epidemiológiai szótár Medicina Kiadó Budapest [Dictionary of Epidemiology].

  • [11] Egészségügyi Statisztikai Évkönyv [Health Statistical Annual] 1996–2006. Központi Statisztikai Hivatal [Central Statistical Office], Budapest, 1997–2008.

    • Search Google Scholar
    • Export Citation

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