Background: ST-segment–elevation myocardial infarction (STEMI) and non–ST-segment–elevation myocardial infarction (NSTEMI) management has evolved considerably over the past 2 decades. Little information on mortality trends in the most recent years is available. We assessed trends in characteristics, treatments, and outcomes for acute myocardial infarction in France between 1995 and 2015.

Methods: We used data from 5 one-month registries, conducted 5 years apart, from 1995 to 2015, including 14 423 patients with acute myocardial infarction (59% STEMI) admitted to cardiac intensive care units in metropolitan France.

Results: From 1995 to 2015, mean age decreased from 66±14 to 63±14 years in patients with STEMI; it remained stable (68±14 years) in patients with NSTEMI, whereas diabetes mellitus, obesity, and hypertension increased. At the acute stage, intended primary percutaneous coronary intervention increased from 12% (1995) to 76% (2015) in patients with STEMI. In patients with NSTEMI, percutaneous coronary intervention ≤72 hours from admission increased from 9% (1995) to 60% (2015). Six-month mortality consistently decreased in patients with STEMI from 17.2% in 1995 to 6.9% in 2010 and 5.3% in 2015; it decreased from 17.2% to 6.9% in 2010 and 6.3% in 2015 in patients with NSTEMI. Mortality still decreased after 2010 in patients with STEMI without reperfusion therapy, whereas no further mortality gain was found in patients with STEMI with reperfusion therapy or in patients with NSTEMI, whether or not they were treated with percutaneous coronary intervention.

Conclusions: Over the past 20 years, 6-month mortality after acute myocardial infarction has decreased considerably for patients with STEMI and NSTEMI. Mortality figures continued to decline in patients with STEMI until 2015, whereas mortality in patients with NSTEMI appears stable since 2010.

背景：在过去的20年中，ST段抬高型心肌梗塞（STEMI）和非ST段抬高型心肌梗塞（NSTEMI）的管理方法已经有了很大的发展。关于最近几年死亡率趋势的信息很少。我们评估了1995年至2015年法国在急性心肌梗死的特征，治疗和预后方面的趋势。

方法：我们使用了1995年至2015年间隔5年，每个月进行5次注册的数据，其中包括法国大都会心脏重症监护病房收治的14 423例急性心肌梗死（占STEMI的59％）。

结果：从1995年到2015年，STEMI患者的平均年龄从66±14岁降低到63±14岁；在NSTEMI患者中，它保持稳定（68±14岁），而糖尿病，肥胖和高血压患者则增加了。在急性期，STEMI患者的原发性经皮冠状动脉介入治疗从12％（1995）增至76％（2015）。NSTEMI患者入院后≤72小时的经皮冠状动脉介入治疗从9％（1995）增加到60％（2015）。STEMI患者的六个月死亡率从1995年的17.2％持续下降至2010年的6.9％和2015年的5.3％; NSTEMI患者的这一比例从2010年的17.2％降至2010年的6.9％和2015年的6.3％。未经再灌注治疗的STEMI患者的死亡率在2010年之后仍然有所下降，

结论：在过去的20年中，STEMI和NSTEMI患者的急性心肌梗死后6个月的死亡率已大大降低。直到2015年，STEMI患者的死亡率持续下降，而NSTEMI患者的死亡率自2010年以来一直保持稳定。