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External validity of ST elevation myocardial infarction trials: The Zwolle studies
- Source :
- Catheterization and Cardiovascular Interventions, 69(5), 632-636. Wiley
- Publication Year :
- 2007
-
Abstract
- Background: Guidelines are mainly based upon results of randomised controlled clinical trials. However, due to low external validity of these trials, their results can not reasonably be applied to all patients in routine practice. In our hospital, all patients with ST-elevation myocardial infarction (STEMI) are eligible for inclusion in one of our ongoing trials or registries. To asses differences between patients enrolled versus not-enrolled in a trial or registry, we evaluated all patients with a discharge diagnose of STEMI during the study period. Methods: Retrospectively, individual patient data from all patients with a discharge diagnosis of STEMI between Jan 2001 and Dec 2001 were evaluated. Follow-up data were obtained until Dec 2004. Results: A total of 583 patients were discharged with a diagnosis of STEMI. About 455 (78%) patients were enrolled in one of the ongoing clinical trials or registry and 128 were not. Not-enrolled patients were significantly older; more often had a history of previous MI and had higher risk profiles. Multivariate analysis revealed that higher age was the only independent predictor for non enrolment. Not-enrolled patients were more often treated conservatively and had a higher mortality rate (36% vs. 6%, P
- Subjects :
- Male
Time Factors
Multivariate analysis
Myocardial Infarction
SEGMENT-ELEVATION
PRIMARY ANGIOPLASTY
Kaplan-Meier Estimate
PARTICIPANTS
Registries
Myocardial infarction
ELDERLY-PATIENTS
Netherlands
Aged, 80 and over
Clinical Trials as Topic
OUTCOMES
Mortality rate
Age Factors
General Medicine
Middle Aged
Patient Discharge
Female
Cardiology and Cardiovascular Medicine
medicine.medical_specialty
CLINICAL-TRIAL
External validity
STEMI
Heart Conduction System
Predictive Value of Tests
St elevation myocardial infarction
Diabetes mellitus
Internal medicine
medicine
Humans
Radiology, Nuclear Medicine and imaging
generalizability
Aged
Retrospective Studies
clinical trials
EARLY INVASIVE MANAGEMENT
business.industry
ACUTE CORONARY SYNDROMES
Reproducibility of Results
medicine.disease
Clinical trial
Logistic Models
THROMBOLYTIC THERAPY
REGISTRY
Multivariate Analysis
Physical therapy
Observational study
business
Follow-Up Studies
Subjects
Details
- Language :
- English
- ISSN :
- 15221946
- Database :
- OpenAIRE
- Journal :
- Catheterization and Cardiovascular Interventions, 69(5), 632-636. Wiley
- Accession number :
- edsair.doi.dedup.....d9072cc2073d7d43a0e2680ed6e1b4d3