Skip Navigation


European Heart Journal Advance Access originally published online on August 9, 2006
European Heart Journal 2006 27(17):2141; doi:10.1093/eurheartj/ehl186
This Article
Right arrow FREE Full Text (PDF) Freely available
Right arrow All Versions of this Article:
27/17/2141    most recent
ehl186v1
Right arrow E-letters: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when E-letters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Karcz, M.
Right arrow Articles by Witkowski, A.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Karcz, M.
Right arrow Articles by Witkowski, A.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

© The European Society of Cardiology 2006. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Clinical trials with ST-segment elevation myocardial infarction

Maciej Karcz

Institute of Cardiology
Warsaw
Poland
Tel: +48 601 29 19 42
Fax: +48 22 613 38 19
E-mail address:
alicjakarcz{at}poczta.onet.pl

Adam Witkowski

Chairman, WG on Interventional Cardiology of the Polish Cardiac Society
Poland

It is with great interest that we read the article ‘Outcomes of patients in clinical trials with ST-segment elevation myocardial infarction among countries with different gross national incomes’ by Orlandini et al.1 We feel obliged to point out that at least what regards Poland as one of the countries with medium gross national income (GNI), some of the data presented are of purely historical value only. The authors state that in the years 1995–2002, only 10.9% of patients participating in clinical trials in medium GNI countries underwent PCI. In Poland, since 2001, the number of STEMI patients treated with primary PCI soared, reaching 22 706 per year in 2005,2 which constitute 34% of all PCI procedures. Given that—according to a recent survey—the incidence of hospitalized STEMI in Poland is between 1000 and 1200 cases per million people each year3 and that the country's population is ca. 38 million, this means that nowadays between 50% and 60% of all hospitalized patients with STEMI are reperfused with primary PCI. As of April 2006, there were 59 Cathlabs throughout our country that provided round-the-clock PCI service, many of them with an yearly volume of 600–700 primary PCI. Pooled data from Poland's hospitals performing primary PCI in year 2003 demonstrate 30-day mortality of 7.0% including patients with cardiogenic shock and 4.7% in patients with no shock.2 It is, at present, unlikely that there could be any underusage of invasive treatment of STEMI in Poland to adversely affect the outcome as compared with high GNI countries. Still, the authors may be right when speculating (p. 531) that in medium- or low-GNI countries, investigators may be ‘including a higher risk subset of patients’ and that ‘significantly greater proportion of patients (...) were randomized’ as compared with high-GNI countries. As a matter of fact, this brings any clinical trial closer to real life and should make its results more relevant for clinical practice.

References

  1. Orlandini A, Diaz R, Wojdyla D, Pieper K, Van de Werf F, Granger CB, Harrington RA, Boersma E, Califf RM, Armstrong P, White H, Simes J, Paolasso E. (2006) Outcomes of patients in clinical trials with ST-segment elevation myocardial infarction among countries with different gross national incomes. Eur Heart J 27:527–533.[Abstract/Free Full Text]
  2. Electronic Database of the Working Group on Interventional Cardiology of the Polish Cardiac Society. Presentations available at www.kardiologiainwazyjna.pl.
  3. Polonski L, Gasior M, Gierlotka M, Kalarus Z, Zembala M, Termin-Pospiech A, Tendera M. (2005) Epidemiologia, leczenie i rokowanie w ostrych zespolach wiencowych na Slasku. Wyniki etapu pilotazowego ogólnopolskiego rejestru ostrych zespolów wiencowych—PL-ACS. Kardiol Pol 62:I22–I27.

Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?



This Article
Right arrow FREE Full Text (PDF) Freely available
Right arrow All Versions of this Article:
27/17/2141    most recent
ehl186v1
Right arrow E-letters: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when E-letters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Karcz, M.
Right arrow Articles by Witkowski, A.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Karcz, M.
Right arrow Articles by Witkowski, A.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?