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Effect of part-time cardiac catheterization facilities in patients with acute myocardial infarction.

Abstract：

BACKGROUND:Although the easy availability of invasive cardiac care facilities is associated with an increase in their use, their influence on outcomes is not clear. We sought to investigate whether a newly available cardiac catheterization laboratory (CCL) performing percutaneous coronary intervention (PCI) on a part-time (PT) basis might improve outcomes in patients with acute myocardial infarction (AMI). METHODS:This was an observational cohort study that included all consecutive patients with AMI admitted to a secondary-level hospital in Spain before and after the PT-CCL opened in January 2006: during 1998-2005 and 2006-2014, respectively. All-cause in-hospital and long-term mortality were the co-primary endpoints. In-hospital complications and length of stay were secondary endpoints. For the analyses, patients were stratified according to propensity-score (PS) quintiles. RESULTS:A total of 5339 patients were recruited, and 50.3% were managed after the opening of the PT-CCL. The PT-CCL was associated with greater use of PCI (81.2 vs. 32.5%, p<0.001) and guidelines-recommended medication (all p<0.001), lower risk of recurrent angina (PS-adjusted RR=0.160, 95% CI 0.115-0.222) and shorter length of hospital stay (PS-adjusted RR for length of stay <8days=0.357, 95% CI 0.301-0.422). In patients with NSTEMI, PT-CCL was associated with improved long-term survival (PS-adjusted HR=0.764, 95% CI 0.602-0.970). CONCLUSIONS:In patients with AMI, a new PT-CCL was associated with greater use of PCI and guideline-recommended medication, lower risk of recurrent angina and shorter length of hospital stay. In a subset of patients with NSTEMI, PT-CCL was associated with improved long-term survival.

journal_name

Int J Cardiol

journal_title

International journal of cardiology

authors

Consuegra-Sánchez L,Jaulent-Huertas L,Vicente-Gilabert M,Díaz-Pastor Á,Escudero-García G,Alonso-Fernández N,Gil-Sánchez FJ,Martínez-Hernández J,Sanchis-Forés J,Galcerá-Tomás J,Melgarejo-Moreno A

doi

10.1016/j.ijcard.2017.02.148

subject

Has Abstract

pub_date

2017-06-01 00:00:00

pages

85-90

eissn

0167-5273

issn

1874-1754

pii

S0167-5273(17)30054-2

journal_volume

236

pub_type

杂志文章

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