Stiftung IHF Institut für Herzinfarktforschung



In 1994, the MITRA registry (Maximal Individual Therapy in Acute Myocardial Infarction) was initiated. Its objective was to document the implementation of medical guidelines in myocardial infarction therapy. This intensive reflection on medical practice resulted in significant improvements of the standards of care. The project turned out to be such an incredible success that more initiatives followed.

A Good Example – Acute Therapy

Benchmarking report (example: Acute therapy)Acute therapy to treat myocardial infarction is based on five components: swift recanalization (re-opening of the blocked vessel) and medical treatment using aspirin, beta blockers, clopidogrel, and ACE inhibitors. Not all the components are appropriate for each and every patient. There are contraindications which have been considered in each documented myocardial infarction. The physician had to give his/her rationale in writing if not all of the five therapy components had been used in a patient. Each hospital received feedback comparing it with the other centers.

Number of therapy elements (Recanalisation, Aspirin, Beta-Blocker, Clopidogrel, ACE inhibitor)A “comparison tool“ allowed the centers to see whether the healthcare standards they applied required improvement. Over a period of 12 years, the registry reflected that improvement in terms of an increase in median therapy component application from 2.4 per patient to 4.4.

Hospital mortality after acute myocardial infarctionThe healthcare improvements – in this case consequent implementation of already existing guidelines - paid off: In the course of the study, post myocardial infarction hospital mortality dropped from 16.2% to 7.9%.


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