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Observational Study
. 2013 Dec;2(4):359-70.
doi: 10.1177/2048872613497341. Epub 2013 Aug 20.

Euro Heart Survey 2009 Snapshot: regional variations in presentation and management of patients with AMI in 47 countries

Etienne Puymirat  1 , Alex Battler, John Birkhead, Hector Bueno, Peter Clemmensen, Yves Cottin, Keith Aa Fox, Bulent Gorenek, Christian Hamm, Kurt Huber, Maddalena Lettino, Bertil Lindahl, Christian Müller, Alexander Parkhomenko, Susanna Price, Tom Quinn, Francois Schiele, Maarten Simoons, Gabriel Tatu-Chitoiu, Marco Tubaro, Christiaan Vrints, Doron Zahger, Uwe Zeymer, Nicolas Danchin; EHS 2009 snapshot participants
Affiliations
Observational Study

Euro Heart Survey 2009 Snapshot: regional variations in presentation and management of patients with AMI in 47 countries

Etienne Puymirat et al. Eur Heart J Acute Cardiovasc Care. 2013 Dec.

Abstract

Aims: Detailed data on patients admitted for acute myocardial infarction (AMI) on a European-wide basis are lacking. The Euro Heart Survey 2009 Snapshot was designed to assess characteristics, management, and hospital outcomes of AMI patients throughout European Society of Cardiology (ESC) member countries in a contemporary 'real-world' setting, using a methodology designed to improve the representativeness of the survey.

Methods: Member countries of the ESC were invited to participate in a 1-week survey of all patients admitted for documented AMI in December 2009. Data on baseline characteristics, type of AMI, management, and complications were recorded using a dedicated electronic form. In addition, we used data collected during the same time period in national registries in Sweden, England, and Wales. Data were centralized at the European Heart House.

Results: Overall, 4236 patients (mean age 66±13 years; 31% women) were included in the study in 47 countries. Sixty per cent of patients had ST-segment elevation myocardial infarction, with 50% having primary percutaneous coronary intervention and 21% fibrinolysis. Aspirin and thienopyridines were used in >90%. Unfractionated and low-molecular-weight heparins were the most commonly used anticoagulants. Statins, beta-blockers, and angiotensin-converting enzyme inhibitors were used in >80% of the patients. In-hospital mortality was 6.2%. Regional differences were observed, both in terms of population characteristics, management, and outcomes.

Conclusions: In-hospital mortality of patients admitted for AMI in Europe is low. Although regional variations exist in their presentation and management, differences are limited and have only moderate impact on early outcomes.

Keywords: Acute myocardial infarction; Europe; hospital outcomes; survey.

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Conflict of interest statement

Conflict of interest: H Bueno: Advisory/consulting fees from AstraZeneca, Bayer, Daichii-Sankyo, Eli-Lilly, Novartis, Roche; research grants from AstraZeneca.

P Clemmensen: Research contracts, consulting or received research and educational grants from Abbott, AstraZeneca, Aventis, Bayer, Bristol Myers Squibb, Daiichi-Sankyo, Eli-Lilly, Merck, Myogen, Medtronic, Mitsubishi Pharma, Nycomed, Organon, Pfizer, Pharmacia, Philips, Roche, Sanofi-Synthelabo, Searle, The Medicines Company.

N Danchin: Research grants from AstraZeneca, Daiichi-Sankyo, Eli-Lilly, GSK, Merck, Novartis, Pfizer, Sanofi-aventis, Servier, The Medicines Company; speaker and consulting fees from AstraZeneca, Bayer, Bristol-Myers Squibb, Boehringer-Ingelheim, Daiichi-Sankyo, Eli-Lilly, GlaxoSmithKline, MSD-Schering, Novartis, Novo-Nordisk, Pfizer, Roche, Sanofi-Aventis, Servier, The Medicines Company.

KAA Fox: Research grants and honoraria from Bayer/ Johnson & Johnson, Lilly, Sanofi Aventis, AstraZeneca, Boehringer-Ingelheim.

K Huber: Lecture fees from AstraZeneca, Bayer, Boehringer Ingelheim, Bristol Myers Squibb, Daiichi Sankyo, Eli Lilly, Pfizer, Sanofi-Aventis, The Medicines Company.

M Lettino: Speaker fees from Astra Zeneca, Daiichi Snkyo, Eli Lilly, Boehringer, Bayer, The Medicines Company, Pfizer; advisory board fees from Boehringer, Eli Lilly, The Medicines Company, BMS, MSD, Pfizer.

C Mueller: Research support from Abbott, Alere, Brahms, Nanosphere, Roche, Siemens, 8sense, Nanosphere, and Department of Internal Medicine, University Hospital Basel; speaker honoraria from Abbott, Alere, Brahms, Lilly, Novartis, Roche, Siemens.

A Parkhomenko: Research grants from Bayer, GSK, Sanofi-aventis, Servier, BHFZ; speaker fees from AstraZeneca, Bayer, Boehringer-Ingelheim, GlaxoSmithKline, Sanofi-Aventis, Servier.

S Price: Educational contract fees from Medtronic; advisory board fees from Abbott; speaking honorarium from Pfizer.

T Quinn: consultancy fees from Boehringer Ingelheim (STREAM trial), MedCo (EUROMAX).

F Schiele: Research grant from GlaxoSmithKline, St Jude Medical, Sanofi-Aventis, Servier, Daiichi-Sankyo/Lilly; lecture fees from Boehringer Ingelheim, Daiichi-Sankyo/Lilly, Novartis, Sanofi-Aventis, Servier, The Medicines Company, Astra Zeneca; consulting fees from Sanofi, Astra Zeneca, Lilly.

C Vrints: Research grants from Abbott, Medtronic, Bracco.

D Zahger: Consultant fees from AstraZeneca, Ely-Lilly, Bayer, Rafa Laboratories, Sanofi-Aventis, Pfizer.

U Zeymer: Research grants from Daiichi Sankyo, Lilly, Novartis, Sanofi-aventis; speakers honoraria from AstraZeneca, Bayer Healthcare, Daiichi Sankyo, Iroko, Lilly, Medicines Company, MSD, Novartis, Sanofi-aventis.

The other authors report no disclosure.

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