P3638The characteristics, treatment and outcomes of patients with acute myocardial infarction from 2012-2015 in Estonian Myocardial Infarction Registry

Abstract

Introduction: The Estonian Myocardial Infarction Registry (EMIR) has been founded in 2012 to improve the diagnostics and treatment of acute myocardial infarction (AMI) and to conduct epidemiological research. Purpose: To describe the baseline characteristics, treatment and mortality of Estonian AMI patients hospitalized during 2012-2015. Material and methods: EMIR collects data on all hospitalized AMI cases in Estonia (ICD 10th version, codes I21-I22); submitting the data online via a specific form is mandatory. The use of personal identification number enables the linkage of EMIR data with other national registries. EMIR collects the following data: patient demographics and medical history, data about current AMI, time points commonly used as quality indicators, diagnostic and treatment methods (incl. medicines), in-hospital adverse events and mortality. Results: During the years 2012-2015 more than 95% of the hospitalized cases were submitted to EMIR. The mean age (72 years), proportion of males (58%) and patients with ST-segment elevation AMI (STEMI, 43%) remained stable. We observed a high rate of patients with diabetes mellitus (25%), hypertension (78%) and dyslipidaemia (57%). In addition, 26% of patients were current smokers and 25% reported previous AMI. The prescription of betablockers, ACEI/ARB and statins showed no major change and remained above 75% during the years studied. The use of P2Y12 inhibitors increased from 66% to 72%, mainly derived from increased utilization of ticagrelor - it was used in 47% of patients in 2015. The rate of patients undergoing percutaneous coronary intervention was quite similar - 55% in 2012, 59% in 2013 and 57% in 2014 and 2015. Among STEMI patients the use of thrombolysis decreased from 15% to 10% (p<0.01) and the use of primary PCI increased from 44% to 49% (p<0.05). The mortality rates have remained relatively stable through the study period except for year 2014 where we observed a lower in-hospital mortality compared to both 2013 and 2015 (Table 1). Conclusion: EMIR provides a comprehensive overview of changes in baseline characteristics, treatment, as well as short- and long-term mortality in a nonselected population of hospitalized AMI patients in a high risk country. (Table Presented).