Reperfusion therapies and in-hospital outcomes for ST-elevation myocardial infarction in Europe: the ACVC-EAPCI EORP STEMI Registry of the European Society of Cardiology
Authors: Zeymer Uwe , Ludman Peter , Danchin Nicolas , Kala Petr , Laroche Cécile , Sadeghi Masoumeh , Caporale Roberto , Shaheen Sameh Mohamed , Legutko Jacek , Iakobsishvili Zaza , Alhabib Khalid F , Motovska Zuzana , Studencan Martin , Mimoso Jorge , Becker David , Alexopoulos Dimitrios , Kereseselidze Zviad , Stojkovic Sinisa , Zelveian Parounak , Goda Artan , Mirrakhimov Erkin , Bajraktari Gani , Al-Farhan Hasan , Šerpytis Pranas , Raungaard Bent , Marandi Toomas , Moore Alice May , Quinn Martin , Karjalainen Pasi Paavo , Tatu-Chitolu Gabriel , Gale Chris P , Maggioni Aldo P , Weidinger Franz ,   the ACVC EAPCI EORP ACS STEMI investigators group of the ESC, Weidinger Franz , Zeymer Uwe , Danchin Nicolas , Ludman Peter , Sinnaeve Peter , Kala Petr , Ferrari Roberto , Maggioni Aldo P , Goda Artan , Zelveian Parounak , Weidinger Franz , Karamfilov Kiril , Motovska Zuzana , Zeymer Uwe , Raungaard Bent , Marandi Toomas , Shaheen Sameh Mohamed , Lidon Rosa-Maria , Karjalainen Pasi Paavo , Kereselidze Zviad , Alexopoulos Dimitrios , Becker David , Quinn Martin , Iakobishvili Zaza , Al-Farhan Hasan , Sadeghi Masoumeh , Caporale Roberto , Mirrakhimov Erkin , Serpytis Pranas , Erglis Andrejs , Kedev Sasko , Moore Alice May , Dudek Dariusz , Legutko Jacek , Mimoso Jorge , Tatu-Chitoiu Gabriel , Stojkovic Sinisa , Shlyakhto Evgeny , AlHabib Khalid F , Bunc Matjaz , Studencan Martin , Mourali Mohamed Sami , Bajraktari Gani , Konte Marème , Larras Florian , Lefrancq Elin Folkesson , Mekhaldi Souad , Laroche Cécile , Maggioni Aldo P , Goda A , Shuka N , Pavli E , Tafaj E , Gishto T , Dibra A , Duka A , Gjana A , Kristo A , Knuti G , Demiraj A , Dado E , Hasimi E , Simoni L , Siqeca M , Sisakian H , Hayrapetyan H , Markosyan S , Galustyan L , Arustamyan N , Kzhdryan H , Pepoyan S , Zirkik A , Von Lewinski D , Paetzold S , Kienzl I , Matyas K , Neunteufl T , Nikfardjam M , Neuhold U , Mihalcz A , Glaser F , Steinwender C , Reiter C , Grund M , Hrncic D , Hoppe U , Hammerer M , Hinterbuchner L , Hengstenberg C , Delle Karth G , Lang I , Weidinger F , Winkler W , Hasun M , Kastner J , Havel C , Derntl M , Oberegger G , Hajos J , Adlbrecht C , Publig T , Leitgeb M-C , Wilfing R , Jirak P , Ho C-Y , Puskas L , Schrutka L , Spinar J , Parenica J , Hlinomaz O , Fendrychova V , Semenka J , Sikora J , Sitar J , Groch L , Rezek M , Novak M , Kramarikova P , Stasek J , Dusek J , Zdrahal P , Polasek R , Karasek J , Seiner J , Sukova N , Varvarovsky I , Lazarák T , Novotny V , Matejka J , Rokyta R , Volovar S , Belohlavek J , Motovska Z , Siranec M , Kamenik M , Kralik R , Raungaard B , Ravkilde J , Jensen S E , Villadsen A , Villefrance K , Schmidt Skov C , Maeng M , Moeller K , Hasan-Ali H , Ahmed T A , Hassan M , ElGuindy A , Farouk Ismail M , Ibrahim Abd El-Aal A , El-sayed Gaafar A , Magdy Hassan H , Ahmed Shafie M , Nabil El-khouly M , Bendary A , Darwish M , Ahmed Y , Amin O A , AbdElHakim A , Abosaif K , Kandil H , Galal M A G , El Hefny E E , El Sayed M , Aly K , Mokarrab M , Osman M , Abdelhamid M , Mantawy S , Ali M R , Kaky S D , Khalil V A , Saraya M E A , Talaat A , Nabil M , Mounir W M , Mahmoud K , Aransa A , Kazamel G , Anwar S , Al-Habbaa A , Abd el Monem M , Ismael A , Amin Abu-Sheaishaa M , Abd Rabou M M , Hammouda T M A , Moaaz M , Elkhashab K , Ragab T , Rashwan A , Rmdan A , AbdelRazek G , Ebeid H , Soliman Ghareeb H , Farag N , Zaki M , Seleem M , Torki A , Youssef M , AlLah Nasser N A , Rafaat A , Selim H , Makram M M , Khayyal M , Malasi K , Madkour A , Kolib M , Alkady H , Nagah H , Yossef M , Wafa A , Mahfouz E , Faheem G , Magdy Moris M , Ragab A , Ghazal M , Mabrouk A , Hassan M , El-Masry M , Naseem M , Samir S , Marandi T , Reinmets J , Allvee M , Saar A , Ainla T , Vaide A , Kisseljova M , Pakosta U , Eha J , Lotamois K , Sia J , Myllymaki J , Pinola T , Karjalainen P P , Paana T , Mikkelsson J , Ampio M , Tsivilasvili J , Zurab P , Kereselidze Z , Agladze R , Melia A , Gogoberidze D , Khubua N , Totladze L , Metreveli I , Chikovani A , Eitel I , Pöss J , Werner M , Constantz A , Ahrens C , Zeymer U , Tolksdorf H , Klinger S , Sack S , Heer T , Lekakis J , Kanakakis I , Xenogiannis I , Ermidou K , Makris N , Ntalianis A , Katsaros F , Revi E , Kafkala K , Mihelakis E , Diakakis G , Grammatikopoulos K , Voutsinos D , Alexopoulos D , Xanthopoulou I , Mplani V , Foussas S , Papakonstantinou N , Patsourakos N , Dimopoulos A , Derventzis A , Athanasiou K , Vassilikos V P , Papadopoulos C , Tzikas S , Vogiatzis I , Datsios A , Galitsianos I , Koutsampasopoulos K , Grigoriadis S , Douras A , Baka N , Spathis S , Kyrlidis T , Hatzinikolaou H , Kiss R G , Becker D , Nowotta F , Tóth K , Szabó S , Lakatos C , Jambrik Z , Ruzsa J , Ruzsa Z , Róna S , Toth J , Vargane Kosik A , Toth K S B , Nagy G G , Ondrejkó Z , Körömi Z , Botos B , Pourmoghadas M , Salehi A , Massoumi G , Sadeghi M , Soleimani A , Sarrafzadegan N , Roohafza H , Azarm M , Mirmohammadsadeghi A , Rajabi D , Rahmani Y , Siabani S , Najafi F , Hamzeh B , Karim H , Siabani H , Saleh N , Charehjoo H , Zamzam L , Al-Temimi G , Al-Farhan H , Al-Yassin A , Mohammad A , Ridha A , Al-Saedi G , Atabi N , Sabbar O , Mahmood S , Dakhil Z , Yaseen I F , Almyahi M , Alkenzawi H , Alkinani T , Alyacopy A , Kearney P , Twomey K , Iakobishvili Z , Shlomo N , Beigel R , Caldarola P , Rutigliano D , Sublimi Saponetti L , Locuratolo N , Palumbo V , Scherillo M , Formigli D , Canova P , Musumeci G , Roncali F , Metra M , Lombardi C , Visco E , Rossi L , Meloni L , Montisci R , Pippia V , Marchetti M F , Congia M , Cacace C , Luca G , Boscarelli G , Indolfi C , Ambrosio G , Mongiardo A , Spaccarotella C , De Rosa S , Canino G , Critelli C , Caporale R , Chiappetta D , Battista F , Gabrielli D , Marziali A , Bernabò P , Navazio A , Guerri E , Manca F , Gobbi M , Oreto G , Andò G , Carerj S , Saporito F , Cimmino M , Rigo F , Zuin G , Tuccillo B , Scotto di Uccio F , Irace L , Lorenzoni G , Meloni I , Merella P , Polizzi G M , Pino R , Marzilli M , Morrone D , Caravelli P , Orsini E , Mosa S , Piovaccari G , Santarelli A , Cavazza C , Romeo F , Fedele F , Mancone M , Straito M , Salvi N , Scarparo P , Severino P , Razzini C , Massaro G , Cinque A , Gaudio C , Barillà F , Torromeo C , Porco L , Mei M , Iorio R , Nassiacos D , Barco B , Sinagra G , Falco L , Priolo L , Perkan A , Strana M , Bajraktari G , Percuku L , Berisha G , Mziu B , Beishenkulov M , Abdurashidova T , Toktosunova A , Kaliev K , Serpytis P , Serpytis R , Butkute E , Lizaitis M , Broslavskyte M , Xuereb R G , Moore A M , Mercieca Balbi M , Paris E , Buttigieg L , Musial W , Dobrzycki S , Dubicki A , Kazimierczyk E , Tycinska A , Wojakowski W , Kalanska-Lukasik B , Ochala A , Wanha W , Dworowy S , Sielski J , Janion M , Janion-Sadowska A , Dudek D , Wojtasik-Bakalarz J , Bryniarski L , Peruga J Z , Jonczyk M , Jankowski L , Klecha A , Legutko J , Michalowska J , Brzezinski M , Kozmik T , Kowalczyk T , Adamczuk J , Maliszewski M , Kuziemka P , Plaza P , Jaros A , Pawelec A , Sledz J , Bartus S , Zmuda W , Bogusz M , Wisnicki M , Szastak G , Adamczyk M , Suska M , Czunko P , Opolski G , Kochman J , Tomaniak M , Miernik S , Paczwa K , Witkowski A , Opolski M P , Staruch A D , Kalarus Z , Honisz G , Mencel G , Swierad M , Podolecki T , Marques J , Azevedo P , Pereira M A , Gaspar A , Monteiro S , Goncalves F , Leite L , Mimoso J , Manuel Lopes dos Santos W , Amado J , Pereira D , Silva B , Caires G , Neto M , Rodrigues R , Correia A , Freitas D , Lourenco A , Ferreira F , Sousa F , Portugues J , Calvo L , Almeida F , Alves M , Silva A , Caria R , Seixo F , Militaru C , Ionica E , Tatu-Chitoiu G , Istratoaie O , Florescu M , Lipnitckaia E , Osipova O , Konstantinov S , Bukatov V , Vinokur T , Egorova E , Nefedova E , Levashov S , Gorbunova A , Redkina M , Karaulovskaya N , Bijieva F , Babich N , Smirnova O , Filyanin R , Eseva S , Kutluev A , Chlopenova A , Shtanko A , Kuppar E , Shaekhmurzina E , Ibragimova M , Mullahmetova M , Chepisova M , Kuzminykh M , Betkaraeva M , Namitokov A , Khasanov N , Baleeva L , Galeeva Z , Magamedkerimova F , Ivantsov E , Tavlueva E , Kochergina A , Sedykh D , Kosmachova E , Skibitskiy V , Porodenko N , Namitokov A , Litovka K , Ulbasheva E , Niculina S , Petrova M , Harkov E , Tsybulskaya N , Lobanova A , Chernova A , Kuskaeva A , Kuskaev A , Ruda M , Zateyshchikov D , Gilarov M , Konstantinova E , Koroleva O , Averkova A , Zhukova N , Kalimullin D , Borovkova N , Tokareva A , Buyanova M , Khaisheva L , Pirozhenko A , Novikova T , Yakovlev A , Tyurina T , Lapshin K , Moroshkina N , Kiseleva M , Fedorova S , Krylova L , Duplyakov D , Semenova Y , Rusina A , Ryabov V , Syrkina A , Demianov S , Reitblat O , Artemchuk A , Efremova E , Makeeva E , Menzorov M , Shutov A , Klimova N , Shevchenko I , Elistratova O , Kostyuckova O , Islamov R , Budyak V , Ponomareva E , Ullah Jan U , Alshehri A M , Sedky E , Alsihati Z , Mimish L , Selem A , Malik A , Majeed O , Altnji I , AlShehri M , Aref A , AlHabib K , AlDosary M , Tayel S , Abd AlRahman M , Asfina K N , Abdin Hussein G , Butt M , Markovic Nikolic N , Obradovic S , Djenic N , Brajovic M , Davidovic A , Romanovic R , Novakovic V , Dekleva M , Spasic M , Dzudovic B , Jovic Z , Cvijanovic D , Veljkovic S , Ivanov I , Cankovic M , Jarakovic M , Kovacevic M , Trajkovic M , Mitov V , Jovic A , Hudec M , Gombasky M , Sumbal J , Bohm A , Baranova E , Kovar F , Samos M , Podoba J , Kurray P , Obona T , Remenarikova A , Kollarik B , Verebova D , Kardosova G , Studencan M , Alusik D , Macakova J , Kozlej M , Bayes-Genis A , Sionis A , Garcia Garcia C , Lidon R-M , Duran Cambra A , Labata Salvador C , Rueda Sobella F , Sans Rosello J , Vila Perales M , Oliveras Vila T , Ferrer Massot M , Bañeras J , Lekuona I , Zugazabeitia G , Fernandez-Ortiz A , Viana Tejedor A , Ferrera C , Alvarez V , Diaz-Castro O , Agra-Bermejo R M , Gonzalez-Cambeiro C , Gonzalez-Babarro E , Domingo-Del Valle J , Royuela N , Burgos V , Canteli A , Castrillo C , Cobo M , Ruiz M , Abu-Assi E , Garcia Acuna J M 
Published: June 2021

Abstract

Aims
The aim of this study was to determine the contemporary use of reperfusion therapy in the European Society of Cardiology (ESC) member and affiliated countries and adherence to ESC clinical practice guidelines in patients with ST-elevation myocardial infarction (STEMI).

Methods and results
Prospective cohort (EURObservational Research Programme STEMI Registry) of hospitalized STEMI patients with symptom onset &lt;24 h in 196 centres across 29 countries. A total of 11 462 patients were enrolled, for whom primary percutaneous coronary intervention (PCI) (total cohort frequency: 72.2%, country frequency range 0–100%), fibrinolysis (18.8%; 0–100%), and no reperfusion therapy (9.0%; 0–75%) were performed. Corresponding in-hospital mortality rates from any cause were 3.1%, 4.4%, and 14.1% and overall mortality was 4.4% (country range 2.5–5.9%). Achievement of quality indicators for reperfusion was reported for 92.7% (region range 84.8–97.5%) for the performance of reperfusion therapy of all patients with STEMI &lt;12 h and 54.4% (region range 37.1–70.1%) for timely reperfusion.

Conclusions
The use of reperfusion therapy for STEMI in the ESC member and affiliated countries was high. Primary PCI was the most frequently used treatment and associated total in-hospital mortality was below 5%. However, there was geographic variation in the use of primary PCI, which was associated with differences in in-hospital mortality.