Jánosi András, Ofner Péter, Merkely Béla, Polgár Péter, Andréka Péter, Zámolyi Károly, Kiss Róbert Gábor, Tomcsányi János, László Zoltán, Vértes András, Varjú Imre, Juhász Ferenc, Simon János, Bajkó Sándor
Gottsegen György Országos Kardiológiai Intézet, Budapest, Haller u. 29. 1096.
Orv Hetil. 2011 Aug 7;152(32):1278-83. doi: 10.1556/OH.2011.29188.
Authors present the methodology and first data of Hungarian Myocardial Infarction Register Pilot Study started 1st of January, 2010. The aim of the study is to collect epidemiological data on myocardial infarction, to examine the natural history of the disease and to investigate the main characteristics on patient care in the pilot area. The program is using standardized diagnostic criteria and predefined electronic data record forms (eCRF). The pilot area consists of 5 districts in the capital, and Szabolcs-Szatmár-Bereg county. The area has 997 324 inhabitants. Eight cardiology departments, 5 with heart catheterization facility (C) in Budapest, four hospitals with one C in Szabolcs-Szatmar-Bereg county have been responsible of the patients' care. After starting the program 16 other hospitals joined the program from different parts of Hungary. Between 1st of January 2010 and 1st of May 2011 4293 patients were registered, among them 52.1% with ST segment elevation myocardial infarction (STEMI), 42.1% with non-ST segment elevation myocardial infarction (NSTEMI), while 3% of the patients had unstable angina, and 2.8% of the cases had other diagnosis or the hospital diagnosis was missing in the eCRF. Authors compare the patients care with STEMI in five districts of Budapest and Szabolcs-Szatmár-Bereg county. In Budapest 79.7% of the 301 STEMI patients were treated in C and 84.6% of them were treated with primary percutaneous intervention (pPCI). In Szabolcs-Szatmár-Bereg county 402 patients were registered with STEMI, 62.9% of them were treated in C, where 77% of them were treated with pPCI. The drugs (beta blockers, ACE inhibitors, statins) important for secondary prevention were given more often to patients treated in the capital, however no difference was found in the platelet aggregation inhibitors therapy. Hospital mortality of STEMI patients was 8% in the capital, and 10% in Szabolcs- Szatmár-Bereg county. Authors conclude that the web based myocardial infarction register is feasible and important to have reliable data on patient care and a necessary quality control tool. Authors propose to broaden this pilot program and to start a nationwide myocardial infarction register.
作者介绍了2010年1月1日启动的匈牙利心肌梗死登记试点研究的方法和首批数据。该研究的目的是收集心肌梗死的流行病学数据，研究疾病的自然史，并调查试点地区患者护理的主要特征。该项目采用标准化诊断标准和预定义的电子数据记录表格（eCRF）。试点地区包括首都的5个区以及绍博尔奇-萨博洛什-贝雷格州。该地区有997324名居民。布达佩斯的8个心脏病学科室，其中5个具备心脏导管插入设备（C），绍博尔奇-萨博洛什-贝雷格州有4家医院各有1个C，负责患者护理。项目启动后，匈牙利其他地区的16家医院加入了该项目。在2010年1月1日至2011年5月1日期间，登记了4293名患者，其中52.1%为ST段抬高型心肌梗死（STEMI），42.1%为非ST段抬高型心肌梗死（NSTEMI），3%的患者患有不稳定型心绞痛，2.8%的病例有其他诊断或电子数据记录表格中缺少医院诊断。作者比较了布达佩斯5个区和绍博尔奇-萨博洛什-贝雷格州STEMI患者的护理情况。在布达佩斯，301例STEMI患者中有79.7%在有心脏导管插入设备的科室接受治疗，其中84.6%接受了直接经皮冠状动脉介入治疗（pPCI）。在绍博尔奇-萨博洛什-贝雷格州，登记了402例STEMI患者，其中62.9%在有心脏导管插入设备的科室接受治疗，其中77%接受了pPCI。对二级预防重要的药物（β受体阻滞剂、血管紧张素转换酶抑制剂、他汀类药物）在首都接受治疗的患者中使用得更频繁，然而在血小板聚集抑制剂治疗方面未发现差异。STEMI患者在首都的医院死亡率为8%，在绍博尔奇-萨博洛什-贝雷格州为10%。作者得出结论，基于网络的心肌梗死登记对于获得可靠的患者护理数据是可行且重要的，并且是必要的质量控制工具。作者提议扩大该试点项目并启动全国性的心肌梗死登记。
