You are here

  • Home
  • Archive
  • Volume 10, Issue 11
  • Comparison of the pathways of care and life courses between first-time ST-elevation myocardial infarction (STEMI) and STEMI with prior MI: findings from the OSCAR registry

Article Text

Article menu

Download PDFPDF

XML
Cardiovascular medicine
Original research
Comparison of the pathways of care and life courses between first-time ST-elevation myocardial infarction (STEMI) and STEMI with prior MI: findings from the OSCAR registry
  1. Laurie Fraticelli1,2,
  2. Olivier Kleitz1,
  3. Clément Claustre1,
  4. Nicolas Eydoux1,
  5. Alexandra Peiretti1,
  6. Karim Tazarourte3,4,
  7. Eric Bonnefoy-Cudraz5,
  8. Claude Dussart2,
  9. Carlos El Khoury4,6
  10. the RESCUe Research Group
    1. 1RESCUe-RESUVal network, Hospital Center Lucien Hussel, Vienne, France
    2. 2Laboratory Systemic Health Care, EA 4129, University of Lyon 1, Lyon, France
    3. 3Department of Emergency Medicine and SAMU, Hospital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
    4. 4HESPER EA 7425, Claude Bernard Lyon 1 University, Lyon, France
    5. 5Cardiology intensive care unit, Hospital Louis Pradel, Groupement Hospitalier Est, Hospices Civils de Lyon, Bron, France
    6. 6Clinical Research Unit and Emergency Department, Médipôle Lyon-Villeurbanne, Villeurbanne, France
    1. Correspondence to Dr Laurie Fraticelli; l.fraticelli{at}resuval.fr

    Abstract

    Objectives We hypothesised that patients having experienced one coronary event in their life were susceptible to present differences in their pathways of care and within 1 year of their life courses. We aimed to compare pathways between first-time ST-elevation myocardial infarction (STEMI) and STEMI with prior myocardial infarction (MI).

    Design A retrospective observational study based on the Observatoire des Syndromes Coronariens Aigus du réseau RESCUe (OSCAR) registry collecting all suspected STEMI from 10 percutaneous coronary intervention centres in France.

    Setting All patients with STEMI from 2013 to 2017 were included (N=6306 with 5423 first-time STEMI and 883 STEMI with prior MI). We provided a matching analysis by propensity score based on cardiovascular risk factors.

    Participants We defined first-time STEMI as STEMI occurring at the inclusion date, and STEMI with prior MI as STEMI with a history of MI prior to the inclusion date.

    Results Patients with first-time STEMI and patients with STEMI with prior MI were equally treated during hospitalisation and at discharge. At 12 months, patients with first-time STEMI had a lower adherence to BASIC treatment (ie, beta-blocker, antiplatelet therapy, statin and converting enzyme inhibitor) (48.11% vs 58.58%, p=0.0167), more frequently completed the cardiac rehabilitation programme (44.33% vs 31.72%, p=0.0029), more frequently changed their lifestyle behaviours; more frequently practiced daily physical activity (48.11% vs 35.82%, p=0.0043) and more frequently stopped smoking at admission (69.39% vs 55.00%, p=0.0524). The estimated mortality was higher for patients with STEMI with prior MI at 1 month (p=0.0100), 6 months (p=0.0500) and 1 year (p=0.0600).

    Conclusions We provided an exhaustive overview of the real-life clinical practice conditions of STEMI management. The patients with STEMI with prior MI presented an optimised use of prehospital resources, which was probably due to their previous experience, and showed a better adherence to drug therapy compared with patients with first-time STEMI.

    Trial registration number Commission Nationale de l’Informatique et des Libertés (number 2 013 090 v0).

    • secondary prevention
    • ST-elevation myocardial infarction
    • recurrence
    • risk reduction behavior
    http://creativecommons.org/licenses/by-nc/4.0/

    This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

    https://doi.org/10.1136/bmjopen-2020-038773

    Statistics from Altmetric.com

      Request Permissions

      If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

      View Full Text

      Footnotes

      • Collaborators On behalf of the RESCUe Research Group: Dr Christophe Robin (Clinique Convert, Bourg en Bresse), Dr Xavier Tchenio (Hôpital Fleyriat, Bourg en Bresse), Dr Pierre Lantelme (Hôpital Nord-ouest site Villefranche), Dr Pierre Lantelme (HCL Groupement Hospitalier Nord, Lyon 4), Pr Eric Bonnefoy-Cudraz (HCL, Groupement Hospitalier Est Hôpital L Pradel-Bron), Dr Jean-Philippe Claudel (Infirmerie Protestante, Caluire-Cuire), Dr Alain Hepp (Clinique la Sauvegarde, Lyon 9), Dr Thibault Perret (Centre Hospitalier Saint Joseph-Saint luc, Lyon 7), Dr Didier Champagnac (Médipôle Privé, Villeurbanne) and Dr Philippe Chapon (Centre Hospitalier de Valence).

      • Contributors LF drafted the manuscript and develop methodology., OK interpreted the results. CC provided statistical analysis. NE and AP collected the data. KT, EB-C and CD provided critical readings. CEK supervised the work.

      • Funding The RESCUe Network is funded by the Regional Agency for Health from Auvergne-Rhône-Alpes region (Agence Régionale de Santé Auvergne-Rhône-Alpes). Grant/Award: not applicable.

      • Competing interests None declared.

      • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

      • Patient consent for publication Not required.

      • Provenance and peer review Not commissioned; externally peer reviewed.

      • Data availability statement Data are available upon reasonable request.