Original article Short- and long-term mortality in patients with ST-elevation myocardial infarction treated with different therapeutic strategies. Results from WIelkopolska REgional 2002 Registry (WIRE Registry)

Backround: Although primary coronary angioplasty seems to be the best treatment in acute myocardial infarction (MI), thrombolytic therapy still remains the most common reperfusion strategy particularly in smaller centers. Nowadays, different regional networks are developed to improve the treatment of patients with MI. Aim: To analyse the effects of different therapeutic strategies on 30-day and long-term mortality (median time 18.3 months) after ST-elevation MI (STEMI) in a population of 3 350 000 people from the Wielkopolska Region. Methods: In 2002, 3780 patients with STEMI entered the registry. Complete data were available for 3564 (94.3%) patients. Depending on therapeutic strategies, patients were divided into five groups: the PCI group – direct percutaneous coronary angioplasty (PCI) in small cathlab, ‘selected patients’, n=381 (10.7%); the PA group – aged Results: The 30-day mortality rate in the groups above was: 3.15, 4.38, 4.54, 9.25, and 12.5% respectively (p Conclusions: Treatment with rt-PA in patients under 70 years of age and up to 4 hours from pain onset may be an alternative to an invasive strategy. However, a quarter of those patients require urgent PCI. In long-term observation the mortality benefit can be clearly seen only in patients with early PCI.