Abstract
The availability and mode of reperfusion therapy for ST elevation acute myocardial infarction (STEMI) vary largely among European countries. This review article brings recent published data including experience from the best practice countries.
The mean annual incidence of hospital admission for any acute myocardial infarction in Europe is 1,934 patients/mil. pop., 796 of them are STEMI. Primary PCI is the dominant reperfusion strategy in two thirds of Europe, while one third of Europe is still using thrombolysis as the dominant reperfusion strategy.
These "thrombolytic" countries leave 46% of STEMI patients without any reperfusion therapy while, in "angioplasty" countries, any reperfusion therapy (PCI or thrombolysis) is used in 78% of STEMI patients. The mean annual incidence of primary PCI is 448/mil. pop.
One European primary PCI centre serves a mean population of 920,000, in "angioplasty" countries, this number is lower, 560,000 inhabitants. Hospital mortality of STEMI patients treated by primary PCI is 4.9%, when treated by thrombolysis, the mean mortality is 9.2%.
The best practice countries for primary PCI (best organisation on the country level with treatment available for nearly all country population) include the Czech Republic, the Netherlands, and Sweden. Primary PCI is available for the majority of population in Austria, Germany, Switzerland, Denmark, Poland, Slovenia, and Norway.
The lowest availability of primary PCI is in the Mediterranean and Balkan states.