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Temporal trends and prognostic impact of reperfusion modalities in Tunisian patients presenting with ST-elevation myocardial infarction: A 20-year analysis.
Jomaa, Walid; Chamtouri, Ikram; Amdouni, Nesrine; Turki, Ahmed; Ben Hamda, Khaldoun.
Afiliación
  • Jomaa W; Cardiology B department, Fattouma Bourguiba University hospital and University of Monastir, Tunisia.
  • Chamtouri I; Cardiology B department, Fattouma Bourguiba University hospital and University of Monastir, Tunisia.
  • Amdouni N; Cardiology B department, Fattouma Bourguiba University hospital and University of Monastir, Tunisia.
  • Turki A; Cardiology B department, Fattouma Bourguiba University hospital and University of Monastir, Tunisia.
  • Ben Hamda K; Cardiology B department, Fattouma Bourguiba University hospital and University of Monastir, Tunisia.
Tunis Med ; 102(7): 387-393, 2024 Jul 05.
Article en En | MEDLINE | ID: mdl-38982961
ABSTRACT

INTRODUCTION:

With the advent of reperfusion therapies, management of patients presenting with ST-elevation myocardial infarction (STEMI) has witnessed significant changes during the last decades.

AIM:

We sought to analyze temporal trends in reperfusion modalities and their prognostic impact over a 20-year period in patients presenting with STEMI the Monastir region (Tunisia).

METHODS:

Patients from Monastir region presenting for STEMI were included in a 20-year (1998-2017) single center registry. Reperfusion modalities, early and long-term outcomes were studied according to five four-year periods.

RESULTS:

Out of 1734 patients with STEMI, 1370 (79%) were male and mean age was 60.3 ± 12.7 years. From 1998 to 2017, primary percutaneous coronary intervention (PCI) use significantly increased from 12.5% to 48.3% while fibrinolysis use significantly decreased from 47.6% to 31.7% (p<0.001 for both). Reperfusion delays for either fibrinolysis or primary PCI significantly decreased during the study period. In-hospital mortality significantly decreased from 13.7% during Period 1 (1998-2001) to 5.4% during Period 5 (2014-2017), (p=0.03). Long-term mortality rate (mean follow-up 49.4 ± 30.7 months) significantly decreased from 25.3% to 13% (p<0.001). In multivariate analysis, age, female gender, anemia on-presentation, akinesia/dyskinesia of the infarcted area and use of plain old balloon angioplasty were independent predictors of death at long-term follow-up whereas primary PCI use and preinfaction angina were predictors of long-term survival.

CONCLUSIONS:

In this long-term follow-up study of Tunisian patients presenting for STEMI, reperfusion delays decreased concomitantly to an increase in primary PCI use. In-hospital and long-term mortality rates significantly decreased from 1998 to 2017.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Reperfusión Miocárdica / Sistema de Registros / Mortalidad Hospitalaria / Intervención Coronaria Percutánea / Infarto del Miocardio con Elevación del ST Límite: Aged / Female / Humans / Male / Middle aged País/Región como asunto: Africa Idioma: En Revista: Tunis Med Año: 2024 Tipo del documento: Article País de afiliación: Túnez Pais de publicación: Túnez

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Reperfusión Miocárdica / Sistema de Registros / Mortalidad Hospitalaria / Intervención Coronaria Percutánea / Infarto del Miocardio con Elevación del ST Límite: Aged / Female / Humans / Male / Middle aged País/Región como asunto: Africa Idioma: En Revista: Tunis Med Año: 2024 Tipo del documento: Article País de afiliación: Túnez Pais de publicación: Túnez