# Evidence-Based Treatments for STEMI Associated with Reduced Mortality

 

 

      DynaMed Weekly Update - Volume 6, Issue 17 

In recent years, a number of evidence-based interventions for cardiovascular disease have been incorporated into clinical practice guidelines. A recent nationwide study in Sweden analyzed a cohort of 61,238 consecutive patients (mean age 70 years) with first-time ST-elevation myocardial infarction (STEMI) from 1996 through 2007. Over this time period, significant increases in the use of evidence-based procedures and medications were accompanied by significant decreases in mortality ([level 2 \[mid-level\] evidence](http://www.epnet.com/dynamed/levels.php)). Primary percutaneous coronary intervention (PCI) rates increased from 12% to 61%, reperfusion rates (either mechanical or pharmacological) increased from 66% to 79%, and revascularization rates increased from 10% to 84%. Rates of medication use increased from 0 to 82% for clopidogrel, 23% to 83% for statins, and 39% to 69% for ACE inhibitors and ARBS (p for trend < 0.001 for each). Use of aspirin, beta blockers, and calcium channel blockers was also significantly increased. Over the same period, mortality dropped significantly: in-hospital mortality fell from 12.5% to 7.2%, 30-day mortality from 15% to 8.6%, and 1-year mortality from 21% to 13.3% (p for trend < 0.001 for each) ([JAMA 2011 Apr 27;305(16):1677](http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=21521849)).

For more information, see the [ST-elevation myocardial infarction (STEMI)](http://search.ebscohost.com/login.aspx?direct=true&site=dynamed&id=AN+115392) topic in DynaMed.