Over the last two decades several new treatments, both pharmacological and mechanical, have become available for the treatment of ST-elevation myocardial infarction (STEMI). \u00a0As a result, several rounds of national and international guidelines have been developed to guide the implementation of these evidence-based treatments in clinical practice. \u00a0However, relatively few data are available on how implementation of such guidelines has influenced clinical outcomes.<\/p>\n
Using data from the RIKS-HIA registry (The Register of Information and Knowledge about Swedish Heart Intensive Care Admission), Jernberg et al. examined the adoption of new treatments and the related chances of short- and long-term survival in consecutive patients with STEMI over a 12-year period. \u00a0The main outcome measures were the estimated and crude proportions of patients treated with different medications and invasive procedures, and mortality over time.<\/p>\n
The authors noted an increase in evidence based treatments: reperfusion increased from 66% to 79% and primary percutaneous coronary intervention from 12% to 61% (P<.001). \u00a0In addition aspirin, clopidogrel, beta-blocker, statin and clopidogrel use all increased. \u00a0Estimated mortality rates decreased over the same period of time: estimated in-hospital mortality fell from 12.5% to 7.2%, while one-year mortality fell from 21% to 13.3% (P<.001). This trend towards lower mortality continued after adjustment.<\/p>\n
Conclusions:<\/strong><\/p>\n In this Swedish registry study, an increase in the prevalence of evidence-based treatments for STEMI was associated with a decrease in mortality that was sustained over 12 years.<\/p>\n