Baseline characteristics, management and outcome
| Early period: year 1998–2000 | Late period: year 2004–2006 | Periods compared | |||||
| Men (n=10151) | Women (n=5546) | p Value | Men (n=9386) | Women (n=4994) | p Value | p Value | |
| Age, in years (SDs) | 66.4 (12.2) | 72.9 (11.5) | <0.001 | 65.9 (12.2) | 72.4 (12.1) | <0.001 | 0.11 |
| Median symptom-to-door time, h:m (IQR) | 2:45 (1:39–5:10) | 3:15 (1:54–6:15) | <0.001 | 3:00 (1:40–5:50) | 3:30 (2:00–6:30) | <0.001 | <0.001† |
| Median time from first ECG to balloon, h:m (IQR) | 1:00 (0:35–1:39) | 0:58 (0:35–1:42) | 0.60 | 1:10 (0:42–1:49) | 1:15 (0:45–1:59) | <0.001 | <0.001† |
| Median time from first ECG to needle, h:m (IQR) | 0:43 (0:27–1:05) | 0:47 (0:30–1:15) | <0.001 | 0:36 (0:20–1:02) | 0:41 (0:23–1:08) | 0.001 | <0.001‡ |
| Comorbidity | |||||||
| Current smoker | 2762 (28.9) | 1220 (23.8) | <0.001 | 2680 (30.9) | 1224 (27.6) | <0.001 | <0.001† |
| Previous myocardial infarction | 1781 (17.5) | 742 (13.4) | <0.001 | 1062 (11.3) | 529 (10.6) | 0.19 | <0.001‡ |
| Previous PCI | 287 (2.9) | 87 (1.6) | <0.001 | 372 (4.0) | 110 (2.2) | <0.001 | <0.001† |
| Previous coronary artery bypass grafting | 307 (3.1) | 58 (1.1) | <0.001 | 308 (3.3) | 82 (1.7) | <0.001 | 0.05† |
| Diabetes mellitus | 1758 (17.3) | 1198 (21.6) | <0.001 | 1679 (17.9) | 1014 (20.3) | <0.001 | 0.82 |
| Hypertension | 2736 (27.2) | 1972 (36.0) | <0.001 | 3053 (32.8) | 2195 (44.5) | <0.001 | <0.001† |
| Congestive heart failure | 586 (5.8) | 518 (9.3) | <0.001 | 406 (4.3) | 455 (9.1) | <0.001 | <0.001‡ |
| Previous stroke | 769 (7.6) | 509 (9.2) | <0.001 | 780 (8.3) | 523 (10.5) | <0.001 | 0.04† |
| Chronic kidney disease | 89 (0.9) | 40 (0.7) | 0.30 | 113 (1.2) | 72 (1.4) | <0.001 | <0.001† |
| Chronic obstructive pulmonary disease | 448 (4.4) | 358 (6.5) | <0.001 | 465 (5.0) | 440 (8.8) | <0.001 | <0.001† |
| Cancer within 3 years | 246 (2.4) | 160 (2.9) | 0.08 | 277 (3.0) | 149 (3.0) | 0.91 | 0.05† |
| Therapy on arrival | |||||||
| Aspirin | 2680 (26.6) | 1512 (27.5) | 0.25 | 2127 (22.9) | 1440 (29.2) | <0.001 | <0.001‡ |
| Other platelet inhibitor | 37 (0.4) | 16 (0.3) | 0.43 | 309 (3.3) | 195 (3.9) | 0.05 | <0.001† |
| Beta-blocker | 2525 (25.1) | 1544 (28.1) | <0.001 | 2194 (23.6) | 1565 (31.8) | <0.001 | 0.57 |
| ACE inhibitor/ARB | 1081 (10.7) | 586 (10.7) | 0.89 | 1553 (16.7) | 924 (18.7) | 0.002 | <0.001† |
| Statin | 750 (7.5) | 318 (5.8) | <0.001 | 1249 (13.4) | 621 (12.6) | 0.16 | <0.001† |
| Oral anticoagulant | 271 (2.7) | 109 (2.0) | 0.006 | 232 (2.5) | 119 (2.4) | 0.76 | 0.91 |
| Calcium channel blocker | 1304 (13.0) | 786 (14.3) | 0.02 | 1075 (11.6) | 722 (14.6) | <0.001 | 0.04‡ |
| Diuretics | 1453 (14.4) | 1520 (27.7) | <0.001 | 1182 (12.7) | 1407 (28.5) | <0.001 | 0.04‡ |
| Digitalis | 388 (3.9) | 343 (6.3) | <0.001 | 156 (1.7) | 214 (4.3) | <0.001 | <0.001‡ |
| Long-acting nitrates | 1053 (10.5) | 679 (12.4) | <0.001 | 487 (5.2) | 435 (8.8) | <0.001 | <0.001‡ |
| CCU procedures and therapies | |||||||
| Echocardiography | 6200 (64.2) | 2970 (57.8) | <0.001 | 6842 (73.7) | 3282 (66.5) | <0.001 | <0.001† |
| Coronary angiography | 2539 (25.0) | 975 (17.6) | <0.001 | 7686 (81.9) | 3316 (66.4) | <0.001 | <0.001† |
| Reperfusion therapy, all | 7194 (70.9) | 3500 (63.1) | <0.001 | 7065 (75.3) | 3174 (63.6) | <0.001 | <0.001† |
| Fibrinolysis (% of all patients) | 6419 (63.3) | 3223 (58.2) | <0.001 | 1944 (21.0) | 1006 (20.4) | 0.44 | <0.001‡ |
| Fibrinolysis (% of patients receiving reperfusion therapy) | 6419 (89.3) | 3223 (92.2) | <0.001 | 1944 (28.0) | 1006 (32.4) | <0.001 | <0.001‡ |
| Primary PCI (% of all patients) | 713 (7.0) | 248 (4.5) | <0.001 | 4898 (52.2) | 2033 (40.7) | <0.001 | <0.001† |
| Primary PCI (% of patients receiving reperfusion therapy) | 713 (9.9) | 248 (7.1) | <0.001 | 4898 (69.3) | 2033 (64.1) | <0.001 | <0.001† |
| Complications | |||||||
| Killip classes II–IV | 2912 (29.5) | 2077 (38.6) | <0.001 | 991 (11.1) | 847 (18.4) | <0.001 | <0.001‡ |
| Major bleeding* | 67 (1.1) | 62 (2.0) | <0.001 | 104 (1.6) | 120 (4.0) | <0.001 | <0.001† |
| Reinfarction during hospital stay | 281 (2.9) | 205 (3.9) | 0.001 | 150 (1.6) | 94 (1.9) | 0.21 | <0.001‡ |
| Therapy at discharge in hospital survivors | |||||||
| Aspirin | 7994 (87.5) | 4004 (86.1) | 0.02 | 8318 (93.6) | 4062 (91.2) | <0.001 | <0.001† |
| Other platelet inhibitor | 800 (8.8) | 330 (7.1) | 0.001 | 6978 (78.5) | 3045 (68.4) | <0.001 | <0.001† |
| Beta-blocker | 7801 (85.4) | 3812 (82.1) | <0.001 | 8105 (91.2) | 3895 (87.5) | <0.001 | <0.001† |
| ACE inhibitor/ARB | 3934 (43.4) | 1952 (42.4) | 0.25 | 5894 (66.4) | 2719 (61.1) | <0.001 | <0.001† |
| Statin | 3991 (44.0) | 1757 (38.1) | <0.001 | 7570 (85.2) | 3279 (73.8) | <0.001 | <0.001† |
| Outcome | |||||||
| Inhospital mortality | 837 (8.3) | 800 (14.5) | <0.001 | 464 (4.9) | 521 (10.4) | <0.001 | <0.001‡ |
| One-year mortality | 1576 (15.5) | 1324 (23.9) | <0.001 | 961 (10.3) | 955 (19.1) | <0.001 | <0.001‡ |
Data presented as n (%) if not otherwise indicated.
↵* Intracranial haemorrhage, mortal bleeding or given blood transfusion in patients treated with reperfusion therapy.
↵† More in late period.
↵‡ More in early period.
PCI, percutaneous coronary intervention; ARB, angiotensin receptor blocker; CCU, coronary care unit.