Table 1.
Demographic Characteristics, Medical Therapies, and Management of Patients With STEMI Among the 5 Periods
| Characteristics* |
Period 1 1989–1994 (N=1337) |
Period 2 1995–1999 (N=960) |
Period 3 2000–2004 (N=1059) |
Period 4 2005–2009 (N=1535) |
Period 5 2010–2017 (N=2698) |
P for Trend |
|---|---|---|---|---|---|---|
| Age, y, mean (SD) | 61.9 (13.8) | 61.8 (12.4) | 62.2 (11.8) | 62.5 (13.1) | 62.1 (12.9) | 0.481 |
| Men, % | 77.0 | 77.9 | 80.4 | 78.1 | 76.9 | <0.001 |
| Smoker, % | 46.2 | 43.2 | 38.1 | 39.8 | 45.0 | <0.001 |
| Hypertension, % | 45.8 | 46.9 | 49.5 | 52.3 | 54.2 | <0.001 |
| Dyslipidemia, % | 39.5 | 39.8 | 50.2 | 56.6 | 58.4 | <0.001 |
| Diabetes mellitus, % | 25.1 | 27.5 | 31.1 | 27.3 | 24.5 | <0.001 |
| Peripheral disease, % | 9.9 | 10.0 | 11.6 | 12.7 | 7.1 | 0.005 |
| Stroke, % | … | … | … | … | 2.3 | … |
| Kidney disease, % | … | … | … | … | 4.8 | … |
| Previous AMI | 19.7 | 17.6 | 17.5 | 15.8 | 12.0 | <0.001 |
| Killip–Kimball class* | <0.001 | |||||
| I | 73.4 | 74.7 | 77.1 | 79.4 | 81.2 | |
| II | 10.8 | 10.1 | 9.8 | 8.8 | 10.4 | |
| III | 8.0 | 8.5 | 7.6 | 5.6 | 2.5 | |
| IV | 7.3 | 6.4 | 5.5 | 5.8 | 6.0 | |
| AMI location | <0.001 | |||||
| Anterior wall | 42.6 | 41.7 | 46.5 | 49.3 | 45.2 | |
| Inferior wall | 57.4 | 58.3 | 53.5 | 50.3 | 54.8 | |
| Medications | ||||||
| Aspirin, % | 91.7 | 92.9 | 93.2 | 96.6 | 97.8 | <0.001 |
| Clopidogrel, % | … | … | 25.4 | 78.6 | 89.3 | <0.001 |
| Ticagrelor, % | … | … | … | … | 2.5 | … |
| Prasugrel, % | … | … | … | … | 12.4 | … |
| GPIIb/IIIa inh. % | … | 0.1 | 12.2 | 38.1 | 25.1 | <0.001 |
| Heparin, % | 59.3 | 64.9 | 71.9 | 64.5 | 71.2 | <0.001 |
| Low‐molecular‐weight heparin, % | 3.8 | 4.4 | 30.7 | 44.0 | 30.7 | <0.001 |
| β‐Blockers, % | 51.0 | 74.2 | 82.7 | 83.7 | 81.3 | <0.001 |
| Statins, % | 1.6 | 0.1 | 26.3 | 75.6 | 88.0 | <0.001 |
| ACE inhibitor/ARB, % | 20.5 | 26.0 | 41.0 | 54.2 | 54.8 | <0.001 |
| Lidocaine, % | 22.9 | 15.8 | 7.6 | 6.0 | 2.4 | <0.001 |
| Amiodarone, % | 7.9 | 8.6 | 7.5 | 6.9 | 4.9 | <0.001 |
| Reperfusion, % | 42.8 | 54.7 | 57.7 | 78.9 | 91.9 | <0.001 |
| Fibrinolysis, % | 100 | 100 | 66.7 | 22.1 | 0.9 | |
| Primary PCI, % | 0 | 0 | 33.3 | 77.9 | 99.1 | |
| Rescue PCI, % | 0 | 0 | 0.7 | 4.6 | 0.9 | |
| Time onset‐reperfusion min, median (IQR) | … | … | 170 (138) | 240 (210) | 185 (170) | <0.001 |
| Coronary angiography | 3.1 | 5.2 | 27.3 | 70.6 | 97 | <0.001 |
| CABG, % | 1.2 | 0.2 | 3.0 | 2.9 | 1.1 | <0.001 |
| PAC, % | 5.1 | 4.8 | 3.5 | 14.6 | 1.5 | <0.001 |
| IABP, % | … | 0.2 | 1.7 | 3.0 | 2.8 | <0.001 |
| LVAD, % | … | … | … | … | 0.9 | … |
ACE indicates angiotensin‐converting enzyme; AMI, acute myocardial infarction; ARB, angiotensin receptor blocker; CABG, coronary artery bypass grafting; GPIIB/IIIa inh, glycoprotein IIb/IIIa inhibitors; IABP, intra‐aortic balloon pump; IQR, interquartile range; LVAD, left ventricular assist device (Impella CP); PAC, pulmonary artery catether; PCI, percutaneous coronary intervention; and STEMI, ST‐segment–elevation myocardial infarction.
a
Maximum Killip–Kimball class.