Optimizing use of revascularization and clinical outcomes in ST-elevation myocardial infarction: Insights from the GUSTO-V trial

Padma Kaul, Wei Ching Chang, A. Michael Lincoff, Philip Aylward, Amadeo Betriu, Christoph Bode, Robert M. Califf, E. Magnus Ohman, Victor Guetta, P. Gabriel Steg, Frans Van De Werf, Paul W. Armstrong

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Aims: To examine the relationship between revascularization within 7 days and 1-year mortality among ST-elevation myocardial infarction patients enrolled in GUSTO-V trial (n = 13 451). To examine the relative contribution of system and patient level factors to the variation in international revascularization rates, and their impact on mortality outcomes. Methods and results: Patients from North America (USA, Canada), Australia, and Europe (UK, France, Germany, Italy, Spain, Poland, Norway, The Netherlands, Belgium, Finland) were included in the study. Revascularization was associated with lower 1-year mortality. Norway, Belgium, Spain, Poland, and Italy also had lower than expected revascularization rates but higher than expected mortality rates. France and USA had almost two times the expected rate of 7-day revascularization, which was associated with modest mortality benefits. Patients' propensity for revascularization based on clinical factors alone was associated with lower 1-year mortality (OR 0.97, 95% CI: 0.96-0.99). Country-level factors had an impact on propensity for revascularization but no impact on 1-year mortality. Conclusion: Our study reveals the potential for some countries with lower than expected 7-day revascularization rates to improve their clinical outcomes. Also highlighted is the possibility for more economically efficient delivery of care in USA and France.

LanguageEnglish
Pages1198-1206
Number of pages9
JournalEuropean Heart Journal
Volume27
Issue number10
DOIs
Publication statusPublished - 1 Jan 2006

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Kaul, P., Chang, W. C., Lincoff, A. M., Aylward, P., Betriu, A., Bode, C., ... Armstrong, P. W. (2006). Optimizing use of revascularization and clinical outcomes in ST-elevation myocardial infarction: Insights from the GUSTO-V trial. European Heart Journal, 27(10), 1198-1206. https://doi.org/10.1093/eurheartj/ehi854
Kaul, Padma ; Chang, Wei Ching ; Lincoff, A. Michael ; Aylward, Philip ; Betriu, Amadeo ; Bode, Christoph ; Califf, Robert M. ; Ohman, E. Magnus ; Guetta, Victor ; Steg, P. Gabriel ; Van De Werf, Frans ; Armstrong, Paul W. / Optimizing use of revascularization and clinical outcomes in ST-elevation myocardial infarction : Insights from the GUSTO-V trial. In: European Heart Journal. 2006 ; Vol. 27, No. 10. pp. 1198-1206.
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abstract = "Aims: To examine the relationship between revascularization within 7 days and 1-year mortality among ST-elevation myocardial infarction patients enrolled in GUSTO-V trial (n = 13 451). To examine the relative contribution of system and patient level factors to the variation in international revascularization rates, and their impact on mortality outcomes. Methods and results: Patients from North America (USA, Canada), Australia, and Europe (UK, France, Germany, Italy, Spain, Poland, Norway, The Netherlands, Belgium, Finland) were included in the study. Revascularization was associated with lower 1-year mortality. Norway, Belgium, Spain, Poland, and Italy also had lower than expected revascularization rates but higher than expected mortality rates. France and USA had almost two times the expected rate of 7-day revascularization, which was associated with modest mortality benefits. Patients' propensity for revascularization based on clinical factors alone was associated with lower 1-year mortality (OR 0.97, 95{\%} CI: 0.96-0.99). Country-level factors had an impact on propensity for revascularization but no impact on 1-year mortality. Conclusion: Our study reveals the potential for some countries with lower than expected 7-day revascularization rates to improve their clinical outcomes. Also highlighted is the possibility for more economically efficient delivery of care in USA and France.",
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Kaul, P, Chang, WC, Lincoff, AM, Aylward, P, Betriu, A, Bode, C, Califf, RM, Ohman, EM, Guetta, V, Steg, PG, Van De Werf, F & Armstrong, PW 2006, 'Optimizing use of revascularization and clinical outcomes in ST-elevation myocardial infarction: Insights from the GUSTO-V trial', European Heart Journal, vol. 27, no. 10, pp. 1198-1206. https://doi.org/10.1093/eurheartj/ehi854

Optimizing use of revascularization and clinical outcomes in ST-elevation myocardial infarction : Insights from the GUSTO-V trial. / Kaul, Padma; Chang, Wei Ching; Lincoff, A. Michael; Aylward, Philip; Betriu, Amadeo; Bode, Christoph; Califf, Robert M.; Ohman, E. Magnus; Guetta, Victor; Steg, P. Gabriel; Van De Werf, Frans; Armstrong, Paul W.

In: European Heart Journal, Vol. 27, No. 10, 01.01.2006, p. 1198-1206.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Optimizing use of revascularization and clinical outcomes in ST-elevation myocardial infarction

T2 - European heart journal

AU - Kaul, Padma

AU - Chang, Wei Ching

AU - Lincoff, A. Michael

AU - Aylward, Philip

AU - Betriu, Amadeo

AU - Bode, Christoph

AU - Califf, Robert M.

AU - Ohman, E. Magnus

AU - Guetta, Victor

AU - Steg, P. Gabriel

AU - Van De Werf, Frans

AU - Armstrong, Paul W.

PY - 2006/1/1

Y1 - 2006/1/1

N2 - Aims: To examine the relationship between revascularization within 7 days and 1-year mortality among ST-elevation myocardial infarction patients enrolled in GUSTO-V trial (n = 13 451). To examine the relative contribution of system and patient level factors to the variation in international revascularization rates, and their impact on mortality outcomes. Methods and results: Patients from North America (USA, Canada), Australia, and Europe (UK, France, Germany, Italy, Spain, Poland, Norway, The Netherlands, Belgium, Finland) were included in the study. Revascularization was associated with lower 1-year mortality. Norway, Belgium, Spain, Poland, and Italy also had lower than expected revascularization rates but higher than expected mortality rates. France and USA had almost two times the expected rate of 7-day revascularization, which was associated with modest mortality benefits. Patients' propensity for revascularization based on clinical factors alone was associated with lower 1-year mortality (OR 0.97, 95% CI: 0.96-0.99). Country-level factors had an impact on propensity for revascularization but no impact on 1-year mortality. Conclusion: Our study reveals the potential for some countries with lower than expected 7-day revascularization rates to improve their clinical outcomes. Also highlighted is the possibility for more economically efficient delivery of care in USA and France.

AB - Aims: To examine the relationship between revascularization within 7 days and 1-year mortality among ST-elevation myocardial infarction patients enrolled in GUSTO-V trial (n = 13 451). To examine the relative contribution of system and patient level factors to the variation in international revascularization rates, and their impact on mortality outcomes. Methods and results: Patients from North America (USA, Canada), Australia, and Europe (UK, France, Germany, Italy, Spain, Poland, Norway, The Netherlands, Belgium, Finland) were included in the study. Revascularization was associated with lower 1-year mortality. Norway, Belgium, Spain, Poland, and Italy also had lower than expected revascularization rates but higher than expected mortality rates. France and USA had almost two times the expected rate of 7-day revascularization, which was associated with modest mortality benefits. Patients' propensity for revascularization based on clinical factors alone was associated with lower 1-year mortality (OR 0.97, 95% CI: 0.96-0.99). Country-level factors had an impact on propensity for revascularization but no impact on 1-year mortality. Conclusion: Our study reveals the potential for some countries with lower than expected 7-day revascularization rates to improve their clinical outcomes. Also highlighted is the possibility for more economically efficient delivery of care in USA and France.

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U2 - 10.1093/eurheartj/ehi854

DO - 10.1093/eurheartj/ehi854

M3 - Article

VL - 27

SP - 1198

EP - 1206

JO - European heart journal

JF - European heart journal

SN - 0195-668X

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