Prehospital management procedural performance an

Authors: N S Vos G Amoroso M J Grundeken A J J Ijsselmuiden R J M van Geuns R Spaargaren J G P Tijssen K T Koch

Publish Date: 2016/08/31

Volume: 24, Issue: 12, Pages: 730-739

PDF Link

Abstract

The aim of this study was to achieve useful insights into prehospital management and procedural performance for STelevation myocardial infarction STEMI in the Netherlands by extrapolating patient characteristics and procedural and clinical outcomes of the Dutch patient cohort from the APPOSITIONIII trialThis is a retrospective analysis from the APPOSITIONIII trial with respect to the geographical borders of STEMI management The APPOSITIONIII trial was a European registry for the use of the STENTYS selfexpandable stent in STEMI patients undergoing primary percutaneous coronary intervention PPCI 965 Patients were enrolled mainly in the Netherlands n = 420 435  of the overall study population Germany n = 165 and France n = 131 The data from the Dutch cohort were compared with both the overall study population and the French and German cohorts respectively as well as the European Society of Cardiology ESC STEMI guidelinesIn this trial there was a wide intercountry variation on symptomtoballoon time 165 minutes 120–318 in the Netherlands 270 minutes 180–650 in Germany and 360 minutes 120–480 in France respectively In general a preload of dual antiplatelet therapy DAPT combined with heparin was more often performed in the Dutch and French cohort than in the German cohort DAPT at discharge was high across the whole APPOSITIONIII population No important differences were seen between the different groups according to the endpoints major adverse cardiac event and stent thrombosisPrimary percutaneous coronary intervention PPCI is the recommended treatment for STelevation myocardial infarction STEMI according to the most recent European Society of Cardiology ESC guidelines 1 The ESC guidelines also make recommendations on appropriateness symptomtoballoon time and standards concomitant medications for performing PPCI in STEMI patients 1To comply with the ESC guidelines most European countries have developed national and/or regional networks and protocols for PPCI and perform quality controls throughout registries A good example is the Swedish Register of Information and Knowledge about Swedish Heart Intensive Care Admission RIKSHIA 2In order to achieve useful insights into prehospital management and procedural performance for STEMI in the Netherlands we extrapolated patient characteristics and clinical outcomes of the Dutch patient cohort from a large postmarket STEMI study the APPOSITIONIII trial 6 using the overall population and ESC STEMI guidelines as reference

Keywords: