The second multicenter observational registry on the management of acute ST-elevation myocardial infarction in the Veneto Region (VENERE 2)

Abstract

We sought to evaluate the epidemiology and the management of ST-elevation acute myocardial infarction (STEMI) in the Veneto Region (VENERE 2) in 2014, 10 years after a similar survey conducted in the early 2000s. Between October 2014 and March 2015, all consecutive patients admitted to the Cardiology Divisions of the Veneto Region with STEMI were enrolled in an observational, prospective, multicenter register, called VENERE 2. The main diagnostic and therapeutic efficiency indicators were analyzed and compared with data from the previous VENERE study performed 10 years earlier. Overall, 1165 patients were enrolled, 902 (77%) with an interval <12 h between symptom onset and diagnosis. The incidence of STEMI was 657/million inhabitants per year (vs 697/million inhabitants in VENERE). For 883 (99%) patients, the chosen reperfusion strategy was primary percutaneous coronary intervention (pPCI) (vs 52.3% in VENERE); among these, 503 (55.8%) alerted the 118 (vs 29.7% in VENERE) and pre-hospital ECG was performed in 319 (35.4%) (vs 0% in VENERE). The proportion of patients who underwent recanalization within 90 min of diagnosis was 76.6% in patients treated in hospitals and 50% in transferred patients (vs 70% and 32% in VENERE, respectively). The median delay between symptom onset and recanalization was 60 min (vs 81 min in VENERE). In-hospital mortality was 5.4% (vs 7.3% in VENERE). The cumulative in-hospital incidence of urgent stroke, reinfarction, urgent revascularization was 5.1% (vs 7.1% in VENERE). The current reperfusion treatment of STEMI in the Veneto Region is pPCI. Compared to the data of the VENERE registry, an improvement of all diagnostic and therapeutic efficiency indicators was observed.