Abstract 17513: Strength of Acute Clinical Management and Weakness of Preventive Efforts - Results of Nationwide Myocardial Infarction Registry From Central Eastern Europe With a 3-year Follow-up

Abstract

Background and aim. A significant bias of national AMI registries have been described recently. Therefore, to assess a comprehensive picture of AMI in Poland, we performed a study on nationwide data of all Polish AMI patients in 2009-2012 to assess incidence, quality of care, and cardiovascular events up to 3 years following AMI. Methods. The database of the only, public, obligatory, health insurer in Poland (NHF)together with the data from Ministry of the Interior, and Central Statistical Office were used (AMI-PL nationwide registry). The AMI cases were selected based on primary diagnosis coded in ICD-10 as I21 or I22. For years 2009-2012 all hospitalisations (N=311,813) in a given year and death records were analysed. Additionally, for 2009, data on hospitalisations, procedures, and deaths in a 3-year follow-up were obtained. Results. The age-standardized incidence of AMI in Poland in 2009 was 196 cases per 100,000 population (176 per 100,000 were hospitalized) with decreasing trend over time (80-90 thousands AMI patients each year per 38 mln of population). The incidence was 2.5 times higher in men than in women. Proportion of STEMI declined over time from 55% to 47% in 2012. The percentage of patients treated with invasive strategy raised from 72% to 81%. Decrease of in-hospital case fatality was observed, from 9.1% to 8.0% in 2012. Age-standardized fatality was essentially equal in women and men. Data for index hospitalization in 2009 and cardiovascular events up to 3 years following discharge are presented in the table. Total costs of index AMI hospitalizations for NHF insurer in 2009 were 203 mln EUR, and during 3 years following discharge additionally 162 mln EUR. Conclusions. In Poland standards of care and early outcomes in AMI are similar to Western countries. However high incidence of AMI in Polish population, approximately 35 to 50% higher when compared to reported in Denmark or England, indicates a need for intensifying primary prevention programmes.