Hailer Birgit, Naber Christoph K, Koslowski Bernd, Budde Thomas, Jacksch Rainer, Sabin Georg, Lange Silke, Erbel Raimund
Medizinische Klinik II, Katholische Kliniken Essen-Nord-West, Philippusstift, Essen.
Herz. 2008 Mar;33(2):153-7. doi: 10.1007/s00059-008-3091-7.
The myocardial infarction network "Herzinfarktverbund Essen" was initiated on September 1, 2004 in order to establish a standardized strategy and therapy for patients with ST elevation myocardial infarction (STEMI) in the city of Essen. The primary goal is the immediate reopening of the infarcted vessel by direct transfer of the patient to a hospital with 24-h stand-by catheter laboratory. The first 1-year follow-up, completed on August 31, 2006, showed a low 1-year mortality rate (11.2%), whereby 7.6% of the patients died in hospital. There was a significant dependency of mortality on age, the prehospital stability of cardiovascular circulation, the amount of left ventricular damage, the TIMI flow after intervention, and the duration of interventional therapy ("puncture-to-balloon" time). The coronary status, anticoagulation therapy as well as diabetes mellitus were also dependent variables, whereas the type of stent showed no influence. The rate of restenosis was greater with bare-metal stents (BMS) compared to the use of drug-eluting stents (DES). There was a low rate of repeated STEMI or NSTEMI (non-ST elevation myocardial infarction; 1.8%, 1.7%). These first long-term data confirm the successful implementation of treatment guidelines for STEMI patients within a standardized strategy in an urban environment.
心肌梗死网络“埃森心肌梗死联盟”于2004年9月1日启动,旨在为埃森市的ST段抬高型心肌梗死(STEMI)患者制定标准化的治疗策略和疗法。主要目标是通过将患者直接转运至配备24小时待命导管实验室的医院,立即开通梗死血管。于2006年8月31日完成的首个1年随访显示,1年死亡率较低(11.2%),其中7.6%的患者在医院死亡。死亡率显著取决于年龄、院前心血管循环稳定性、左心室损伤程度、干预后的TIMI血流以及介入治疗持续时间(“穿刺至球囊”时间)。冠状动脉状况、抗凝治疗以及糖尿病也是相关变量,而支架类型未显示出影响。与使用药物洗脱支架(DES)相比,裸金属支架(BMS)的再狭窄率更高。再次发生STEMI或非ST段抬高型心肌梗死(NSTEMI)的发生率较低(1.8%,1.7%)。这些首批长期数据证实了在城市环境中,按照标准化策略成功实施STEMI患者的治疗指南。