[Pre-hospital care in acute coronary syndromes. Experience of the ARIAM group]

The advance in the treatment of the acute coronary syndromes tries to configure an integral attendance, not only of accelerating the fibrinolytic therapy. The objective of the present work is to evaluate basic measures of the patients' out of hospital attendance with acute coronary syndromes.

Descriptive study.

Hospital center.

Diagnosed patients of myocardial infarction or unstable angina derived to intensive care units of 70 hospitals (ARIAM registry). The patients are classified depending on their previous coronary antecedents and to the system that you/they go first. The attention is evaluated by means of an specific score, with special attention in basic measures: administration of acetylsalicylic acid and nitroglycerin and realization of ECG.

Among 30746 patients, of those that 70.4% was myocardial infarction and 29.6% unstable angina, with 3:1 of relationship male/female, the half score of out of hospital attention reaches 1 point. 48.5% goes for its means, making it the rest for devices of urgent attention. It was administered nitroglycerin to 36.7% and acetylsalicylic acid to 13.1%. Among the patients with antecedents, these proportions remain. Among the devices the presence of antecedents seems neither to determine a different attitude. The temporal evolution has not suffered spectacular changes and the tendency to the observed rise, they are more marked for the less established measures.

Inside the evaluation of the out of hospital attendance to the acute coronary syndromes exist numerous opportunities of improvement that it is necessary to develop to several fronts and where all the sanitary services involved will be implied.