Abstract 2493: The Treatment Paradox in Patients with Acute ST Elevation Myocardial Infarction: Decreasing Rate of Reperfusion Therapy with Increasing Clinical Risk
Background: Guideline recommended therapies have been shown to improve mortality in patients with STEMI. However, in clinical practice high risk patients often are not treated with reperfusion therapy and recommended adjunctive therapies. Therefore we sought to investigate the impact of TIMI risk score on acute therapies in patients with STEMI.
Methods: Patients with STEMI < 12 hours enrolled in two prospective registries (ACOS and GOAL) with patients with acute coronary syndromes were divided into 4 groups according to their TIMI risk score at baseline.
Results: The rate of guideline recommended therapies and hospital mortality in the 4 TIMI risk score groups are shown in the table⇓.
Conclusions: In clinical practice higher risk patients with STEMI are undertreated with respect to early reperfusion and recommended adjunctive therapies, which is associated with a steep increase in hospital mortality. Therefore all efforts should be made to increase guideline adherent therapies in higher risk groups, in order to decrease overall mortality rate in patients with STEMI.