Treatment and Prognosis of Myocardial Infarction Outside Cardiology Departments
Aim: Our aim was to investigate the characteristics, treatment and prognosis of patients with myocardial infarction (MI) treated outside a cardiology department (CD), compared with MI patients treated at a CD. Methods: A cohort of 1310 patients diagnosed with MI at eight Swedish hospitals in 2011 we...
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doaj-35ee7d095f4e4a7db8b2b5e44376a55b2020-12-31T00:04:08ZengMDPI AGJournal of Clinical Medicine2077-03832021-12-011010610610.3390/jcm10010106Treatment and Prognosis of Myocardial Infarction Outside Cardiology DepartmentsAnton Gard0Bertil Lindahl1Nermin Hadziosmanovic2Tomasz Baron3Department of Medical Sciences, Cardiology, Uppsala University, 751 85 Uppsala, SwedenDepartment of Medical Sciences, Cardiology, Uppsala University, 751 85 Uppsala, SwedenDepartment of Medical Sciences, Cardiology, Uppsala University, 751 85 Uppsala, SwedenDepartment of Medical Sciences, Cardiology, Uppsala University, 751 85 Uppsala, SwedenAim: Our aim was to investigate the characteristics, treatment and prognosis of patients with myocardial infarction (MI) treated outside a cardiology department (CD), compared with MI patients treated at a CD. Methods: A cohort of 1310 patients diagnosed with MI at eight Swedish hospitals in 2011 were included in this observational study. Patients were followed regarding all-cause mortality until 2018. Results: A total of 235 patients, exclusively treated outside CDs, were identified. These patients had more non-cardiac comorbidities, were older (mean age 83.7 vs. 73.1 years) and had less often type 1 MIs (33.2% vs. 74.2%), in comparison with the CD patients. Advanced age and an absence of chest pain were the strongest predictors of non-CD care. Only 3.8% of non-CD patients were investigated with coronary angiography and they were also prescribed secondary preventive pharmacological treatments to a lesser degree, with only 32.3% having statin therapy at discharge. The all-cause mortality was higher in non-CD patients, also after adjustment for baseline parameters, both at 30 days (hazard ratio (HR) 2.28; 95% confidence interval (CI) 1.62–3.22), one year (HR 1.82; 95% CI 1.39–2.36) and five years (HR 1.62; 95% CI 1.32–1.98). Conclusions: MI treatment outside CDs is associated with an adverse short- and long-term prognosis. An improved use of percutaneous coronary intervention (PCI) and secondary preventive pharmacological treatment might improve the long-term prognosis in these patients.https://www.mdpi.com/2077-0383/10/1/106myocardial infarctionacute cardiac carecardiology department |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Anton Gard Bertil Lindahl Nermin Hadziosmanovic Tomasz Baron |
spellingShingle |
Anton Gard Bertil Lindahl Nermin Hadziosmanovic Tomasz Baron Treatment and Prognosis of Myocardial Infarction Outside Cardiology Departments Journal of Clinical Medicine myocardial infarction acute cardiac care cardiology department |
author_facet |
Anton Gard Bertil Lindahl Nermin Hadziosmanovic Tomasz Baron |
author_sort |
Anton Gard |
title |
Treatment and Prognosis of Myocardial Infarction Outside Cardiology Departments |
title_short |
Treatment and Prognosis of Myocardial Infarction Outside Cardiology Departments |
title_full |
Treatment and Prognosis of Myocardial Infarction Outside Cardiology Departments |
title_fullStr |
Treatment and Prognosis of Myocardial Infarction Outside Cardiology Departments |
title_full_unstemmed |
Treatment and Prognosis of Myocardial Infarction Outside Cardiology Departments |
title_sort |
treatment and prognosis of myocardial infarction outside cardiology departments |
publisher |
MDPI AG |
series |
Journal of Clinical Medicine |
issn |
2077-0383 |
publishDate |
2021-12-01 |
description |
Aim: Our aim was to investigate the characteristics, treatment and prognosis of patients with myocardial infarction (MI) treated outside a cardiology department (CD), compared with MI patients treated at a CD. Methods: A cohort of 1310 patients diagnosed with MI at eight Swedish hospitals in 2011 were included in this observational study. Patients were followed regarding all-cause mortality until 2018. Results: A total of 235 patients, exclusively treated outside CDs, were identified. These patients had more non-cardiac comorbidities, were older (mean age 83.7 vs. 73.1 years) and had less often type 1 MIs (33.2% vs. 74.2%), in comparison with the CD patients. Advanced age and an absence of chest pain were the strongest predictors of non-CD care. Only 3.8% of non-CD patients were investigated with coronary angiography and they were also prescribed secondary preventive pharmacological treatments to a lesser degree, with only 32.3% having statin therapy at discharge. The all-cause mortality was higher in non-CD patients, also after adjustment for baseline parameters, both at 30 days (hazard ratio (HR) 2.28; 95% confidence interval (CI) 1.62–3.22), one year (HR 1.82; 95% CI 1.39–2.36) and five years (HR 1.62; 95% CI 1.32–1.98). Conclusions: MI treatment outside CDs is associated with an adverse short- and long-term prognosis. An improved use of percutaneous coronary intervention (PCI) and secondary preventive pharmacological treatment might improve the long-term prognosis in these patients. |
topic |
myocardial infarction acute cardiac care cardiology department |
url |
https://www.mdpi.com/2077-0383/10/1/106 |
work_keys_str_mv |
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