Quality control for acute myocardial infarction

The Ludwigshafen myocardial infarction project has demonstrated, that an in tense public media campaign can reduce prehospital delays in acute myocardi al infarction. With an additional intrahospital improvement, this can lead to a better and more frequent use of recanalization (thrombolysis or percut aneous transluminal coronary angioplasty [PTCA]). Several large multicentric registries (60 minutes myocardial infarction pro ject, MIR, MITRA) with a total of about 40,000 patients at over 300 hospita ls in Germany showed, that intrahospital improvement of infarction therapy can also be achieved in other hospitals. Voluntary participation in an infa rction registry leads to quality control and improvement. Two factors are e specially important: (1) documentation of every infarction patient, and (2) documentation of the reasons why therapy was given or withheld in every si ngle patient. The improvement in early therapy is associated with a 20% red uction of hospital mortality (MITRA-1). The media campaign in Ludwigshafen to reduce prehospital patient delay, however, could not yet be carried out in other areas effectively and intensely enough.