caa a22 4500 606240012 CHVBK 20210128101306.0 cr unu---uuuuu 210128e20150701xx s 000 0 eng 10.1007/s00508-015-0827-2 doi (NATIONALLICENCE)springer-10.1007/s00508-015-0827-2 One-year mortality in patients with acute ST-elevation myocardial infarction in the Vienna STEMI registry [Elektronische Daten] [Bernhard Jäger, Serdar Farhan, Karim Kalla, Helmut D. Glogar, Günter Christ, Ronald Karnik, Georg Norman, Herbert Prachar, Wolfgang Schreiber, Alfred Kaff, Andrea Podczeck-Schweighofer, Franz Weidinger, Thomas Stefenelli, Georg Delle-Karth, Anton N. Laggner, Gerald Maurer, Kurt Huber] Summary: Background and aim: Systems of care to treat acute ST-elevation myocardial infarction (STEMI) have been developed world wide in the past decade. Their effectiveness can only be proven by including and analyzing outcome data of consecutive patients in registries, which is not the case in the majority of STEMI networks. This study investigates 1-year mortality in STEMI patients in Vienna included over a 14 months time interval. The Vienna STEMI network is organized by a specific rotational system and offers both, primary percutaneous intervention (PPCI) and thrombolytic therapy (TT) as reperfusion strategies according to the recent guidelines. Methods: At the time of investigation, the Vienna STEMI network consisted of the Viennese Ambulance Systems and five high-volume interventional cardiology departments. This network has been organized in order to increase the number of STEMI patients admitted for PPCI and to offer the fastest available reperfusion strategy, in the majority PPCI but in selected patients also TT (STEMI of short duration, mainly anterior wall MI and mainly patients younger than 75 years), followed by rescue PCI in non-responders and elective angiography with/without PCI in responders to TT during the index hospital stay. Results: One-year all-cause mortality rates in the Vienna STEMI network by use of the fastest available reperfusion strategy were 13.4 % in patients who received reperfusion therapy after 2h of symptom onset and 7.4 % in patients treated within 2h; (p = 0.017). Whereas PPCI and TT demonstrated a nonsignificant difference in 1-year mortality rates when initiated within 2h of symptom onset (10.0 % vs 5.7 %; p = 0.59), PPCI was more effective in acute STEMI of > 2h duration as compared to TT but this difference did not reach statistical significance (12.1 % vs 18.2 %; p = 0.07). Conclusions: The reassuring long-term results of the Viennese STEMI network are another example of a specific regional system of care to offer timely diagnosis, transfer and reperfusion in patients with STEMI. In contrast to other metropolitan areas where TT has almost completely abandoned, we still use pharmacological reperfusion as a backup in case of expected and unacceptable time delays for PPCI in order to reduce myocardial damage especially in patients with larger infarctions of short duration with a low risk of bleeding complications. Springer-Verlag Wien, 2015 STEMI nationallicence Network nationallicence Mortality nationallicence Jäger Bernhard 3rd Medical Department, Cardiology and Intensive Care Medicine, Wilhelminenhospital, Montleartstrasse 37, 1160, Vienna, Austria aut Farhan Serdar 3rd Medical Department, Cardiology and Intensive Care Medicine, Wilhelminenhospital, Montleartstrasse 37, 1160, Vienna, Austria aut Kalla Karim 3rd Medical Department, Cardiology and Intensive Care Medicine, Wilhelminenhospital, Montleartstrasse 37, 1160, Vienna, Austria aut Glogar Helmut D. Department of Cardiology, Medical University Vienna, Vienna, Austria aut Christ Günter Department of Cardiology, Medical University Vienna, Vienna, Austria aut Karnik Ronald 2nd Medical Department, Cardiology, Krankenhaus Rudolfstiftung, Vienna, Austria aut Norman Georg 1st Medical Department, Cardiology, Sozialmedizinisches Zentrum Ost, Vienna, Austria aut Prachar Herbert 4th Medical Department, Cardiology, Krankenhaus Hietzing, Vienna, Austria aut Schreiber Wolfgang Department of Emergency Medicine, University of Medicine, Vienna, Austria aut Kaff Alfred Ambulance Services Vienna, Vienna, Austria aut Podczeck-Schweighofer Andrea 5th Medial Department, Cardiology, Sozialmedizinsiches Zentrum Süd, Vienna, Austria aut Weidinger Franz 2nd Medical Department, Cardiology, Krankenhaus Rudolfstiftung, Vienna, Austria aut Stefenelli Thomas 1st Medical Department, Cardiology, Sozialmedizinisches Zentrum Ost, Vienna, Austria aut Delle-Karth Georg 4th Medical Department, Cardiology, Krankenhaus Hietzing, Vienna, Austria aut Laggner Anton N. Department of Emergency Medicine, University of Medicine, Vienna, Austria aut Maurer Gerald Department of Cardiology, Medical University Vienna, Vienna, Austria aut Huber Kurt 3rd Medical Department, Cardiology and Intensive Care Medicine, Wilhelminenhospital, Montleartstrasse 37, 1160, Vienna, Austria aut Wiener klinische Wochenschrift Springer Vienna 127/13-14(2015-07-01), 535-542 0043-5325 127:13-14<535 2015 127 508 https://doi.org/10.1007/s00508-015-0827-2 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00508-015-0827-2 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Jäger Bernhard 3rd Medical Department, Cardiology and Intensive Care Medicine, Wilhelminenhospital, Montleartstrasse 37, 1160, Vienna, Austria aut NATIONALLICENCE 700 1- Farhan Serdar 3rd Medical Department, Cardiology and Intensive Care Medicine, Wilhelminenhospital, Montleartstrasse 37, 1160, Vienna, Austria aut NATIONALLICENCE 700 1- Kalla Karim 3rd Medical Department, Cardiology and Intensive Care Medicine, Wilhelminenhospital, Montleartstrasse 37, 1160, Vienna, Austria aut NATIONALLICENCE 700 1- Glogar Helmut D. Department of Cardiology, Medical University Vienna, Vienna, Austria aut NATIONALLICENCE 700 1- Christ Günter Department of Cardiology, Medical University Vienna, Vienna, Austria aut NATIONALLICENCE 700 1- Karnik Ronald 2nd Medical Department, Cardiology, Krankenhaus Rudolfstiftung, Vienna, Austria aut NATIONALLICENCE 700 1- Norman Georg 1st Medical Department, Cardiology, Sozialmedizinisches Zentrum Ost, Vienna, Austria aut NATIONALLICENCE 700 1- Prachar Herbert 4th Medical Department, Cardiology, Krankenhaus Hietzing, Vienna, Austria aut NATIONALLICENCE 700 1- Schreiber Wolfgang Department of Emergency Medicine, University of Medicine, Vienna, Austria aut NATIONALLICENCE 700 1- Kaff Alfred Ambulance Services Vienna, Vienna, Austria aut NATIONALLICENCE 700 1- Podczeck-Schweighofer Andrea 5th Medial Department, Cardiology, Sozialmedizinsiches Zentrum Süd, Vienna, Austria aut NATIONALLICENCE 700 1- Weidinger Franz 2nd Medical Department, Cardiology, Krankenhaus Rudolfstiftung, Vienna, Austria aut NATIONALLICENCE 700 1- Stefenelli Thomas 1st Medical Department, Cardiology, Sozialmedizinisches Zentrum Ost, Vienna, Austria aut NATIONALLICENCE 700 1- Delle-Karth Georg 4th Medical Department, Cardiology, Krankenhaus Hietzing, Vienna, Austria aut NATIONALLICENCE 700 1- Laggner Anton N. Department of Emergency Medicine, University of Medicine, Vienna, Austria aut NATIONALLICENCE 700 1- Maurer Gerald Department of Cardiology, Medical University Vienna, Vienna, Austria aut NATIONALLICENCE 700 1- Huber Kurt 3rd Medical Department, Cardiology and Intensive Care Medicine, Wilhelminenhospital, Montleartstrasse 37, 1160, Vienna, Austria aut NATIONALLICENCE 773 0- Wiener klinische Wochenschrift Springer Vienna 127/13-14(2015-07-01), 535-542 0043-5325 127:13-14<535 2015 127 508