| Authors | R G Xuereb M Xuereb A Borg M.A Sammut |
| Abstract | Background: The last decade has witnessed a major upheaval in the treatment strategies of ST segment elevation myocardial infarction (STEMI) in Malta, particularly with the introduction of an on-call invasive team for primary percutaneous coronary intervention (pPCI) for anterior STEMI, increased use of coronary artery bypass surgery, aspirin, ACE inhibitors, ?-blockers and statins and a reduction in the use of diuretics, calcium channel blockers, lignocaine and digoxin. The aim of the study was to evaluate whether this has resulted in an improvement in prognosis. Furthermore, we wanted to investigate whether age, sex and residential status affected the treatment strategies and outcome. Methods: All patients (pts) admitted to the coronary care unit are registered. Data of pts with STEMI were derived from review of case notes. Pts were studied during 1991-92 (period I) and 2001-02 (period II) for comparison of in-hospital and 1 year mortality. The influence of age, gender and tourist / resident status on the treatment strategy and outcome was studied during period II. Results: The in-hospital mortality was 11.1% (period I) and 13.6% (period II)(p=0.33), the post-discharge 1 year mortality was 7.8% (period I) and 4.3% (period II) (p=0.1). Fewer pts in the advanced age groups and fewer female patients underwent pPCI and received statins, ?-blockers and ACE inhibitors. Conclusion: Despite the dramatic progress in reperfusion treatment over the past decade, there has not been an improvement in the in-hospital mortality. Although residential status does not affect treatment strategy and outcome, advanced age and female pts receive sub-maximal treatment strategies. |
Published in: | |
| Journal | Malta Medical Journal |
| Volume | 15 Issue 1-2/suppl. 2003 |
| Pages | - |
| Date | |
| Link to journal | |
| Key words | ST segment elevation myocardial infarction, ST segment elevation myocardial infarction, mortality |