Data and thoughts on the short- and long-term prognosis of patients with myocardial infarction and cardiac rehabilitation activities in Hungary
Gottsegen György Országos Kardiovaszkuláris Intézet, Nemzeti Szívinfarktus Regiszter, Budapest
Analyzing the data of the Hungarian Myocardial Infarction Registry the author reviews the most important data of patients with myocardial infarction in Hungary and compares them with the results of other countries. The frequency of revascularization interventions was 80.6% for ST-elevation myocardial infarction (STEMI) and 44.6% for non-ST-elevation myocardial infarction (NSTEMI). Compared to Estonian, Norwegian and Swedish data, the rate of primary PCI in STEMI infarction was the most common in Hungary, while the Swedish practice was the most optimal for PCI performed in the NSTEMI patient group, where this intervention was performed in more than half of the patients (55.3%). In Sweden and Hungary, the majority of patients received drug treatment, which is important from the point of view of secondary prevention. In Estonia and Norway, the indication for these treatments fell short of the optimal value in the case of several preparations. The age-adjusted 30-day and 1-year mortality data were the most favourable in Sweden (8.8% and 13.1%, respectively), and the domestic data were the most unfavourable (15.2% and 23.3% respectively). In Hungary, one-third of patients who survive a heart attack are rehabilitated in an institution. For men, this rate is slightly higher than for women (32.2% vs. 34.7%). The rate of institutional rehabilitation is significantly related to the patient’s place of residence: in some counties, more than half of the patients are rehabilitated, in other counties this rate does not even reach 5%. The most important conclusion of the present analysis is that in our country, long-term treatment is insufficient for most patients and does not meet the recommendations.