Kampfer J, et al. – A comparison was performed of the outcome and quality of secondary prevention in patients after acute myocardial infarction (MI) residing in countries with different socioeconomic environments. Significant variations in the treatment and secondary prevention measures based on low–income, middle–income and high–income socioeconomic situation displayed a correlation with a threefold difference in mortality 3.5 years, after the acute event. Countries with low socioeconomic environment ought to raise their efforts and be supported to improve care including secondary prevention. A greater number of percutaneous coronary interventions (PCI) per million inhabitants itself did not warrant lower mortality scores.

Methods

• This research included patients with a first MI in three different tertiary-care teaching hospitals in Bern (Switzerland), Gdansk (Poland) and Lutsk (Ukraine) during the acute phase in the year 2010 and follow-up of these patients with a questionnaire and, if necessary, telephone interviews 3.5 years after the acute event.
• It constituted all consecutive patients hospitalised in every one of the three study centres during the year 2010 for a first MI in the age ≤75 years who survived ≥30 days.

Results

• A high proportion of patients with ST-segment elevation myocardial infarction (STEMI) were noted in Gdansk (Poland) (80%) and in Lutsk (Ukraine) (74%), while the ratio of STEMIs to non-STEMIs was nearly 50:50 in Bern (Switzerland) (50.6% STEMIs).
• The first choice therapy was percutaneous coronary intervention (PCI) both in Bern (Switzerland) (100%) and in Gdansk (Poland) (92%).
• In contrast, it was not performed at all in Lutsk (Ukraine).
• Significant variations were determined in the treatment and also in secondary prevention interventions including cardiac rehabilitation.
• All-cause mortality at 3.5 year follow-up was 4.6% in Bern (Switzerland), 8.5% in Gdansk (Poland) and 14.6% in Lutsk (Ukraine).