(Press-News.org) CHICAGO – The overall rate of death in patients hospitalized with ST-segment elevation myocardial infarction (STEMI; a certain pattern on an electrocardiogram following a heart attack) decreased from 1995 to 2010 in France, with possible factors associated with this decline including an increase in the proportion of STEMI patients who were women younger than age 60, and an increase in the use of reperfusion therapy and recommended therapeutic measures following a heart attack, according to a study being published online by JAMA. The study is being released early to coincide with its presentation at the European Society of Cardiology Congress.
"Several sources, including registries specific to acute myocardial infarction [AMI; heart attack] and large administrative or billing databases, have shown a decrease in mortality in patients with STEMI over the past 10 to 15 years. This decline is usually attributed to increased use and improved delivery of reperfusion therapy, in particular primary percutaneous coronary intervention (PCI; procedures such as balloon angioplasty or stent placement used to open narrowed coronary arteries). We hypothesized that, beyond primary PCI, other factors such as temporal changes in patient population characteristics may account for part of the observed reduction in mortality of patients with STEMI," the authors write.
Etienne Puymirat, M.D., of the Hôpital Européen Georges Pompidou, Paris, and colleagues conducted a study to assess the association between changes in early mortality following STEMI and patient management and risk profile. The researchers analyzed data from four 1-month French nationwide registries, conducted 5 years apart (in 1995, 2000, 2005 and 2010), which included a total of 6,707 STEMI patients admitted to intensive care or coronary care units.
During the study period, the average age of patients with STEMI declined from 66.2 years to 63.3 years, and history of cardiovascular disease, such as heart attack, heart failure, peripheral artery disease, stroke or transient ischemic attack also decreased. The proportion of younger women (60 years or less) with STEMI increased from 11.8 percent to 25.5 percent, consistent with their increased prevalence of smoking (from 37.3 percent to 73.1 percent) and obesity (from 17.6 percent to 27.1 percent). The proportion of younger patients developing STEMI despite not having hypertension, diabetes, or hypercholesterolemia increased markedly, particularly in younger women.
The authors also found that the use of reperfusion therapy increased over time, from 49.4 percent to 74.7 percent, with more frequent use of primary PCI, (11.9 percent to 60.8 percent). The use of evidence-based treatments during the first 48 hours from admission increased gradually over the 15-year period, including the early use of b-blockers, ACE inhibitors or angiotensin-receptor blockers, and statins. Also, there was increasing early use of antiplatelet agents and low-molecular-weight heparins.
Thirty-day mortality decreased from 13.7 percent in 1995 to 4.4 percent in 2010; mortality decreased from 9.8 percent to 2.6 percent in men and from 23.7 percent to 9.8 percent in women. Consistent with the decrease in mortality, major hospital complications of STEMI also decreased over this time period.
In addition, time from symptom onset to hospital admission decreased, with a shorter time from onset to first call, and broader use of mobile intensive care units.
"The progressive decline in early mortality over time observed in the present nationwide surveys is consistent with many other sources in the United States and Europe," the authors note.
"Within the STEMI population targeted by these sequential registries, the relative proportion of older patients has decreased, while the proportion of younger men and the proportion and numbers of younger women have increased. These observations suggest that future reductions in the incidence and mortality related to AMI will need specific targeting of preventive measures toward younger women and possibly younger men."
###
(doi:10.1001/2012.jama.11348. Available pre-embargo to the media at http://media.jamanetwork.com)
Editor's Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
To contact corresponding author Nicolas Danchin, M.D., Ph.D., email nicolas.danchin@egp.aphp.fr.
END
The New Harmony Soap Company is initiating a program to support the Mt. Vernon, Indiana Food Pantry by donating 5% of sales made online at http://www.newharmonysoap.com and in the outlet store located at 512 N. Main Street in New Harmony, Indiana.
The program begins retroactively, starting July 1, 2012 and will continue through September 30, 2012. Donated funds will be used to purchase peanut butter and toilet paper, two staples the Pantry was forced to eliminate earlier this year due to budget limitations. The Mt. Vernon Food Pantry is located at 601 Canal Street, Hedges ...
American author Jared Romey published Speaking Chileno, a book about Chilean slang that explains more than 2,000 words and phrases in English. Speaking Chileno: A Guide to Spanish from Chile, became a bestseller in Chile when published in 2010 and now is available for the United States and European markets.
The light-hearted book includes bilingual sections about local grammar, pronunciation and gestures, plus 29 illustrations. A collection of 13 useful tables denominated "Quick Vocabulary Guides" group common terms together with topics such as food, clothing, ...
Angel, married for a time to the violent, Michael Murphy, has recovered from the trauma of a bad marriage, rebuilt her life and taken definite steps to ensure that never happens again. She treats herself to a long-promised holiday in Greece, but immediately the past begins to catch up with her.
First, she spots her ex-husband in Athens and then meets her old boss from New York, the man who introduced her to Michael. She also makes the acquaintance of an American, Josh Smith, who spins her one story after another. Can this guy really be trusted?
Angel suddenly finds ...
Candleinfinity Features Top Name Brand Seda France Candles. Candleinfinity adds the Luxury Seda France Candles to Online Store. The Seda France scented 10 oz candles have an elegant, stylish packaging with their signature "no wrapping paper needed". The sophisticated fragrances are perfect for any room or office. The top selling fragrances are Japanese Quince, French Tulip, and Elegant Gardenia.
Candleinfinity is an online retailer that is driven and dedicated to providing the best quality products and customer service. Candleinfinity is a company that implements ...
Gilead Sanders, a leading futurist and consulting firm specializing in helping companies, organizations and individuals take a quantum leap into the 21st century global marketplace has begun operations in South Florida. The firm is the latest venture of noted futurist, author and digital strategist Marvin Dejean. The company serves companies seeking to redesign and realign their existing business models to better thrive in a global marketplace.
"The world has changed overnight. Businesses that are busy operating with the same mindset before this global recession ...
Since their recent addition to Nutty Steph's chocolate shop, three new truffle flavors: Marzipan Cherry, Coconut Cluster, and Strawberry & Cream grace the antique glass candy case there. The aesthetically pleasing look of the truffles appeals to customers, who recognize at first bite that these handcrafted truffles made with kitchen fresh, top quality ingredients, are no ordinary chocolates.
Like all Nutty Steph products, the truffles are handmade and contain top of the line ingredients such as Ecuadorian chocolate with a high cacao content. They are crafted old ...
Wedding Cakes artist Michael learned his craft when he was 16 while growing up in New York working in several bakeries during school summer breaks. About a year later he attended a Culinary Arts School where he reinstated his love for baking and got the highest scores for is artistic skills in Wedding Cakes baking and decorations showing a particular attitude in completing tasks even when assigned at the last moment.
No wonder today he has been establishing his reputation in Las Vegas as Michael the artist that can deliver Wedding Cakes at the last minute order!
Michael ...
Lori Torline, President of Lori Leigh Designs , Inc. announced today that her fashion and jewelry accessory product atelier has appointed The Southern Link to handle retail sales activity in the key states of North and South Carolina, Tennessee, Georgia, Florida, Alabama and Mississippi.
"The Southern Link is one of the most experienced and most respected sales agencies in the retail gift industry", said Ms. Torline. "The lines they represent are among the strongest in the gift and fashion accessory categories and they are most adept at pioneering exciting ...
With the release of Illinois Evidence Rules, Courtroom Quick Reference, attorneys in Illinois have a new legal reference book that can be used in the courtroom, chambers, office or at home. This book contains the complete Illinois Rules of Evidence, effective January 1, 2012 (and current with all 2012 amendments), the Federal Rules of Evidence, effective December 1, 2011, and the Traditional Federal Rules of Evidence, effective through November 30, 2011.
The Federal Rules of Evidence are the fourth set of federal rules to be restyled as part of what is known as "The ...
In the year that Florida school grades dropped because of stricter Florida Comprehensive Assessment Test standards, one local school stands out for achieving an "A" grade against all odds.
Team Success A School of Excellence in Bradenton, a charter school serving about 300 elementary and middle school students from the poorest neighborhoods, has climbed from an "F" school to an "A" school in just two years, after a concerted effort by school administrators and teachers to raise student performance.
"We set our minds to do it and ...
