{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,2]],"date-time":"2025-11-02T10:18:22Z","timestamp":1762078702514,"version":"build-2065373602"},"reference-count":33,"publisher":"BMJ","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Heart"],"published-print":{"date-parts":[[2005,7]]},"abstract":"<jats:p>\n                  <jats:bold>Objective:<\/jats:bold> To document the trends in reperfusion therapy for ST segment elevation myocardial infarction (STEMI) in Switzerland.<\/jats:p>\n               <jats:p>\n                  <jats:bold>Design:<\/jats:bold> National prospective multicentre registry, AMIS Plus (acute myocardial infarction and unstable angina in Switzerland), of patients admitted with acute coronary syndromes.<\/jats:p>\n               <jats:p>\n                  <jats:bold>Setting:<\/jats:bold> 54 hospitals of varying size and capability in Switzerland.<\/jats:p>\n               <jats:p>\n                  <jats:bold>Patients:<\/jats:bold> 7098 of 11 845 AMIS Plus patients who presented with ST segment elevation or left bundle branch block on the ECG at admission.<\/jats:p>\n               <jats:p>\n                  <jats:bold>Main outcome measures:<\/jats:bold> In-hospital mortality and its predictors at admission by multivariate analysis.<\/jats:p>\n               <jats:p>\n                  <jats:bold>Results:<\/jats:bold> The proportion of patients treated by primary percutaneous coronary intervention (PCI) progressively increased from 1997 to 2002, while the proportion with thrombolysis or no reperfusion decreased (from 8.0% to 43.1%, from 47.2% to 25.6%, and from 44.8% to 31.4%, respectively). Overall in-hospital mortality decreased over the study period from 12.2% to 6.7% (p &lt; 0.001). Main in-hospital mortality predictors by multivariate analysis were primary PCI (odds ratio (OR) 0.52, 95% confidence interval (CI) 0.33 to 0.81), thrombolysis (OR 0.63, 95% CI 0.47 to 0.83), and Killip class III (OR 3.61, 95% CI 2.49 to 5.24) and class IV (OR 5.97, 95% CI 3.51 to 10.17) at admission. When adjusted for the year, multivariate analysis did not show PCI to be significantly superior to thrombolysis for in-hospital mortality (OR 1.2 for PCI better, 95% CI 0.8 to 1.9, p \u200a=\u200a 0.42).<\/jats:p>\n               <jats:p>\n                  <jats:bold>Conclusion:<\/jats:bold> Primary PCI has become the preferred mode of reperfusion for STEMI since 2002 in Switzerland, whereas use of intravenous thrombolysis has decreased from 1997 to 2002. 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