The analysis of four French registries from 1995 to 2010 was presented by Professor Nicolas Danchin from the Hopital Europen Georges Pompidou.
Cardiologists recognize two types of myocardial infarction. The first type, ST-elevation myocardial infarction (STEMI), corresponds to the sudden, permanent occlusion of a coronary artery supplying the myocardium (cardiac muscle), usually manifesting as a prolonged, intense chest pain (what is known as a heart attack); it is a true medical emergency, as prompt reopening of the occluded artery will lead to myocardial salvage and limit the consequences of infarction. The second type, non-ST-segment elevation infarction (NSTEMI), is caused by partial or intermittent blockage of an artery, and leads to a more progressive and more limited destruction of myocardial cells; it does not usually require immediate coronary intervention.
"Over the past 15 years, the global picture of acute myocardial infarction has undergone profound changes," said Professor Danchin. "First, improvements in biological techniques have led to an easier recognition of myocardial cell death, thereby increasing the number of patients with documented myocardial necrosis (i.e. myocardial infarction) considered to have NSTEMI. Second, major changes in patient management have been implemented, following the results of numerous clinical trials in patients with myocardial infarction."
Every five years since 1995 in France, nationwide surveys of patients admitted to intensive care units for acute myocardial infarction during a one-month period have been implemented. Using data from the four registries from 1995 to 2010, the researchers sought to determine: 1) potential changes in the population of patients with heart attacks; 2) changes in their management; and 3) changes in clinical outcomes.
In all, 10,610 patients participated (1995: 2,152; 2000: 2,320; 2005: 3,059; 2010: 3,079). The proportion of patients with NSTEMI (199
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European Society of Cardiology