Abstract 16256: Trends in Reperfusion Strategy 1995-2011 in Sweden. Results From the SWEDEHEART Registry
Introduction: Treatment strategy of patients with acute coronary syndrome presenting with STEMI/LBBB has changed over time from thrombolysis to primary PCI (pPCI).
Methods: Patients (n=116982) treated in Sweden 1995-2011 in SWEDEHEART, a national registry in Sweden, were compared in terms of reperfusion strategy over time, by gender and age and for bleeding complications.
Results: The proportion of patients undergoing acute reperfusion increased from 64% to 83% among patients <80 years. Acute thrombolysis was the predominant reperfusion treatment in 1995 with 57% vs 4% pPCI and 4.3% vs 67% pPCI in 2011.
Corresponding numbers including all ages were for thrombolysis 52% vs 3.6% pPCI in 1995 and 4.1% vs 61.8% in 2011. The proportion of women undergoing reperfusion increased from 52% to 61% and among men from 59% to 71% in 2011 and in lower frequency among patients >80 years for both genders. Acute angiography but without reperfusion occurred on average in 2-3%. Acute CABG occurred only in around 0.1% per year. During the same period, in-hospital fatal or intracerebral bleeding complications decreased from 0.7% to 0.15% (all ages). Bleedings requiring surgery or transfusion has remained stable over time.
Conclusions: Reperfusion strategy has changed dramatically over time from mainly thrombolysis in 1995 to primary PCI in 2011, with the only exception of remote areas with long transportation times. During the same period, fatal/intracerebral bleeding complications have decreased. The change is consistent in both men and women and for all ages.
- © 2013 by American Heart Association, Inc.