AIMS: The aim of this study was to determine the contemporary use of reperfusion therapy in the European Society of Cardiology (ESC) member and affiliated countries and adherence to ESC clinical practice guidelines in patients with ST-elevation myocardial infarction (STEMI). METHODS AND RESULTS: Prospective cohort (EURObservational Research Programme STEMI Registry) of hospitalized STEMI patients with symptom onset <24 h in 196 centres across 29 countries. A total of 11 462 patients were enrolled, for whom primary percutaneous coronary intervention (PCI) (total cohort frequency: 72.2%, country frequency range 0-100%), fibrinolysis (18.8%; 0-100%), and no reperfusion therapy (9.0%; 0-75%) were performed. Corresponding in-hospital mortality rates from any cause were 3.1%, 4.4%, and 14.1% and overall mortality was 4.4% (country range 2.5-5.9%). Achievement of quality indicators for reperfusion was reported for 92.7% (region range 84.8-97.5%) for the performance of reperfusion therapy of all patients with STEMI <12 h and 54.4% (region range 37.1-70.1%) for timely reperfusion. CONCLUSIONS: The use of reperfusion therapy for STEMI in the ESC member and affiliated countries was high. Primary PCI was the most frequently used treatment and associated total in-hospital mortality was below 5%. However, there was geographic variation in the use of primary PCI, which was associated with differences in in-hospital mortality.

Aalborg University Hospital Department of Cardiology Hobrovej 18 22 9100 Aalborg Denmark

Ain shams University Ramsis Street Abbassia Square Cairo Egypt

Cardiac Rehabilitation Research Center Cardiovascular Research Institute Isfahan University of Medical Sciences Shahid Rahmani Alley Moshtagh Sevom Street Isfahan Iran

Cardiocenter 3rd Faculty of Medicine Charles Univ and Univ Hospital Kralovske Ruská 2411 100 00 Praha 10 Vinohrady Czech Republic

Cardiology 1 and Cardiology 2 University Hospital Center Mother Theresa Rruga e Dibrës 372 Tirana AL 1000 Albania

Centro Hospitalar e Universitário do Algarve R Leao Penedo 8000 386 Faro Portugal

Chapidze Emergency Cardiology Center 0159 Didube Chugureti District Nino Javakhishvili str Tbilisi Georgia

Department of Cardiac Sciences King Fahad Cardiac Center College of Medicine King Saud University Riyadh Saudi Arabia

Deputy Director of the Heart and Vascular Center of Semmelweis University Gaál József út 9 1122 Budapest Hungary

EURObservational Research Programme European Society of Cardiology European Heart House 2035 Route des Colles Sophia Antipolis France

Faculty of Medicine University of Belgrade Belgrade Serbia Department of Cardiology Clinical Center of Serbia Pasterova 2 Beograd 11000 Belgrade Serbia

Hôpital Européen Georges Pompidou Service de Cardiologie 20 Rue Leblanc 75015 Paris France

Hospital Rudolfstiftung Juchgasse 25 1030 Wien Austria

Institute of Cardiovascular Sciences University of Birmingham Edgbaston 1 Birmingham B15 2TT United Kingdom

Interventional Cardiology Unit Annunziata Civil Hospital Via Migliori 1 87100 Cosenza Italy

Iraqi Scientific Council of Cardiology Baghdad Heart Center Medical City Baghdad Iraq

Jagiellonian University Medical College; Institute of Cardiology Department of Interventional Cardiology John Paul 2 Hospital Prądnicka 80 31 202 Kraków Poland

Klinikum der Stadt Ludwigshafen and Institut für Herzinfarktforschung Bremserstraße 79 67063 Ludwigshafen am Rhein Germany

Kyrgyz State Medical Academy 92 Akhunbayev St Bishkek Kyrgyzstan

Leeds Institute for Cardiovascular and Metabolic Medicine University of Leeds School of Medicine Worsley Building University of Leeds LS2 9JT Leeds UK

Maria Cecilia Hospital GVM Care and Research Via Corriera 1 48033 Cotignola RA Italy

Mater Dei Hospital Triq Dun Karm L Imsida MSD2090 Msida Malta

Medical Faculty University of Prishtina Hasan Prishtina University Clinical Centre of Kosova Pristina 10000 Kosovo

National and Kapodistrian University of Athens Attikon University Hospital Rimini 1 Chaidari 124 62 Greece

National Center of Cardiology and Internal Medicine Togolok Moldo Str 720040 Bishkek Kyrgyzstan

North Estonia Medical Centre J Sütiste tee 19 13419 Tallinn Estonia

Rabin Medical Center Zeev Jabotinsky St 39 Petah Tikva 49100 Israel

Satakunta Cental Hospital Sairaalantie 3 28500 Pori Finland

Scientific Research Institute of Cardiology named after Levon Hovhannisyan 0014 Yerevan Paruyr Sevaki St 5 Building Yerevan Armenia

Spitalul Clinic de Urgenta Floreasca Calea Floreasca 8 București 014461 Romania

St Vincent's University Hospital Merrion Rd Dublin 4 D04 N2E0 Ireland

Teaching Hospital of J A Reiman Cardiocentre Prešov Jána Hollého 5898 14 081 81 Prešov Slovakia

University Hospital Brno Medical Faculty of Masaryk University Dept of Internal Medicine and Cardiology Kamenice 5 625 00 Bohunice Brno Czech Republic

Vilnius University Faculty of Medicine Hospital Santaros Klinikos 08406 Santariškių g 2 Vilnius 08410 Lithuania

Eur Heart J. 2021 Nov 21;42(44):4550-4552. doi: 10.1093/eurheartj/ehab596. PubMed

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Patient characteristics, treatment strategy, outcomes, and hospital costs of acute coronary syndrome: 3 years of data from a large high-volume centre in Central Europe