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[Acute myocardial infarction in Chilean hospitals. Final results of the GEMI study]
J C Prieto1, R Corbalán, E Chávez
1Centro Cardiovascular, Hospital Clínico Universidad de Chile, Santiago, Chile.
Insights
This study reveals key characteristics and treatments for acute myocardial infarction (heart attack) patients in Chilean hospitals. While treatments largely align with international standards, there is significant room for optimization to improve outcomes.
Area of Science:
- Cardiology
- Public Health
Context:
- Acute myocardial infarction (heart attack) represents a critical health challenge in Chile.
- Understanding patient demographics and treatment patterns is vital for improving cardiovascular care.
Purpose:
- To detail the primary features, hospital course, complications, and pharmacological interventions for patients diagnosed with acute myocardial infarction in Chilean hospitals.
- To provide a comprehensive overview of acute myocardial infarction management within the Chilean healthcare system.
Summary:
- A 1993-1995 study analyzed 2,957 acute myocardial infarction patients across 37 Chilean hospitals.
- The average patient was 62 years old, predominantly male (74%), with high rates of hypertension (46%) and smoking (40%).
- Common treatments included aspirin (93%), intravenous nitrates (95%), and heparin (59%), though advanced interventions like angioplasty (9%) and bypass surgery (8%) were less frequent. Hospital mortality was 13.4%, notably higher in women.
Impact:
- This research offers a crucial snapshot of acute myocardial infarction care in Chile.
- Findings suggest that while pharmacological treatments are comparable to international practices, opportunities exist for optimizing patient management and reducing mortality.
- Highlights the need for targeted interventions to address gender disparities in mortality rates.
Background:
Acute myocardial infarction is the leading cause of death in Chile.
Aim:
To report the main features, hospital evolution, complications and pharmacological treatment of patients admitted to Chilean hospitals with the diagnosis of acute myocardial infarction.
Patients And Methods:
Between 1993 and 1995, the GEMI group registered 2,957 patients admitted to 37 hospitals with the diagnosis of acute myocardial infarction.
Results:
Mean age of patients was 62 +/- 2 years old and 74% were male. Forty six percent had a history of hypertension and 40% were smokers. During the first five days of admission, 93% of patients received aspirin, 95% received intravenous nitrates, 59% intravenous heparin, 56% oral nitrates, 37% beta blockers, 32% angiotensin-converting enzyme inhibitors, 33% thrombolytic agents, 29% antiarrhythmics and 23% calcium antagonists. Coronary angiograms were performed in 28% of patients, angioplasty in 9% and 8% were subjected to a coronary bypass. Global hospital mortality was 13.4% (19.5% in women and 11.1% in men, p < 0.001).
Conclusions:
This work gives a picture of myocardial infarction in Chilean hospitals. Pharmacological treatment is similar to that used abroad, but certainly it can be optimized.