AustralieFrV1, Main, Exploration, bibRecord, 009D22

Optimizing use of revascularization and clinical outcomes in ST-elevation myocardial infarction : insights from the GUSTO-V trial

Identifieur interne : 009D22 ( Main/Exploration ); précédent : 009D21; suivant : 009D23

Optimizing use of revascularization and clinical outcomes in ST-elevation myocardial infarction : insights from the GUSTO-V trial

Auteurs : Padma Kaul [Canada] ; Wei-Ching Chang [Canada] ; A. Michael Lincoff [États-Unis] ; Philip Aylward [Australie] ; Amadeo Betriu [Espagne] ; Christoph Bode [Allemagne] ; Robert M. Califf [États-Unis] ; E. Magnus Ohman [États-Unis] ; Victor Guetta ; P. Gabriel Steg [France] ; Frans Van De Werf [Belgique] ; Paul W. Armstrong [Canada]

Source :

European heart journal [ 0195-668X ] ; 2006.

RBID : Pascal:06-0250579

Descripteurs français

Pascal (Inist)
- Infarctus myocarde, Optimisation, Utilisation, Revascularisation, Pronostic, Evolution, Susdécalage ST, Appareil circulatoire, Cardiologie, Phlébologie.

English descriptors

KwdEn :
- Cardiology, Circulatory system, Evolution, Myocardial infarction, Optimization, Phlebology, Prognosis, Revascularization, ST elevation, Use.

Abstract

Aims To examine the relationship between revascularization within 7 days and 1-year mortality among ST-elevation myocardial infarction patients enrolled in GUSTO-V trial (n = 13 451). To examine the relative contribution of system and patient level factors to the variation in international revascularization rates, and their impact on mortality outcomes. Methods and results Patients from North America (USA, Canada), Australia, and Europe (UK, France, Germany, Italy, Spain, Poland, Norway, The Netherlands, Belgium, Finland) were included in the study. Revascularization was associated with lower 1-year mortality. Norway, Belgium, Spain, Poland, and Italy also had lower than expected revascularization rates but higher than expected mortality rates. France and USA had almost two times the expected rate of 7-day revascularization, which was associated with modest mortality benefits. Patients' propensity for revascularization based on clinical factors alone was associated with lower 1-year mortality (OR 0.97, 95% Cl: 0.96-0.99). Country-level factors had an impact on propensity for revascularization but no impact on 1-year mortality. Conclusion Our study reveals the potential for some countries with lower than expected 7-day revascularization rates to improve their clinical outcomes. Also highlighted is the possibility for more economically efficient delivery of care in USA and France.

Affiliations:

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Le document en format XML

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<front><div type="abstract" xml:lang="en">Aims To examine the relationship between revascularization within 7 days and 1-year mortality among ST-elevation myocardial infarction patients enrolled in GUSTO-V trial (n = 13 451). To examine the relative contribution of system and patient level factors to the variation in international revascularization rates, and their impact on mortality outcomes. Methods and results Patients from North America (USA, Canada), Australia, and Europe (UK, France, Germany, Italy, Spain, Poland, Norway, The Netherlands, Belgium, Finland) were included in the study. Revascularization was associated with lower 1-year mortality. Norway, Belgium, Spain, Poland, and Italy also had lower than expected revascularization rates but higher than expected mortality rates. France and USA had almost two times the expected rate of 7-day revascularization, which was associated with modest mortality benefits. Patients' propensity for revascularization based on clinical factors alone was associated with lower 1-year mortality (OR 0.97, 95% Cl: 0.96-0.99). Country-level factors had an impact on propensity for revascularization but no impact on 1-year mortality. Conclusion Our study reveals the potential for some countries with lower than expected 7-day revascularization rates to improve their clinical outcomes. Also highlighted is the possibility for more economically efficient delivery of care in USA and France.</div>
</front>
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Serveur d'exploration sur les relations entre la France et l'Australie

Optimizing use of revascularization and clinical outcomes in ST-elevation myocardial infarction : insights from the GUSTO-V trial

Optimizing use of revascularization and clinical outcomes in ST-elevation myocardial infarction : insights from the GUSTO-V trial

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