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European Heart Journal 2000 21(9):740-746; doi:10.1053/euhj.1999.1858
Copyright © 2000 by the European Society of Cardiology.
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Differences in use of coronary angiography and outcome of myocardial infarction in Toulouse (France) and Gerona (Spain)

J Marrugata,f1, J Ferrièresb, R Masiàc, J Ruidavetsb and J Salac

a Unitat de Lípids i Epidemiologia Cardiovascular, Institut Municipal d'Investigació Mèdica, Barcelona, Spain
b MONICA-Toulouse Project, Département d'Epidemiologie, Faculté de Médecine Toulouse Purpan, Toulouse, France
c Servei de Cardiologia, Hospital Josep Trueta, Gerona, Spain

revised July 13, 1999; accepted July 22, 1999

Abstract

Methods and Results The 28-day case fatality of patients aged 35 to 64 years with myocardial infarction, surviving the first hour post-admission to hospitals with coronary care units, was compared in the population of myocardial infarction registries of Toulouse, France and Gerona, Spain. Patient characteristics were similar. In Toulouse, 93% of the 819 registered patients underwent coronary angiography compared with only 6% of the 454 in Gerona. Among hospitalized patients 28-day case fatality was 4·3% and 9·3% in Toulouse and Gerona, respectively (P=0·0003). Rates of thrombolysis and beta-blocker use were higher in Toulouse, although severity indicators were similar to those of Gerona. A model adjusted for these variables showed that the risk of death was 1·90 (95% confidence interval: 1·17–3·07) in Gerona patients compared with those of Toulouse.

Conclusions Routine angiography use is associated with better 28-day myocardial infarction prognosis than restrictive use. However, the optimum proportion of myocardial infarction patients who have to receive angiography procedures remains unclear.

Key Words: Myocardial infarction, coronary angiography, health services research

f1 Correspondence: Jaume Marrugat MD, Unitat de Lipids i Epidemiologia Cardiovascular, Institut Municipal d'Investigació Mèdica, Carrer Doctor Aiguader, 80; E-08003—Barcelona, Spain.


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