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A provincial hospital C.C.U. after ISIS 2
M O'Riordan1, S Kingston, P O'Regan
1St. Joseph's Hospital, Clonmel.
Irish Journal of Medical Science
|June 1, 1991
Summary
This study on myocardial infarction (M.I.) patients found delays in treatment and low use of beta-blockers. Aspirin use was high at discharge, but risk factor screening, like cholesterol checks, was notably low in the community.
Area of Science:
- Cardiology
- Public Health
Background:
- The Isis study highlighted benefits of streptokinase and aspirin for myocardial infarction (M.I.).
- Coronary care units (CCUs) aim to improve outcomes for acute cardiac events.
Purpose of the Study:
- To evaluate M.I. patient admissions to an Irish CCU.
- To compare treatment patterns with the Isis 2 study.
- To analyze risk factors and pre-hospital care.
Main Methods:
- Prospective study of 115 patients admitted with suspected M.I.
- Diagnosis confirmed in 41 patients.
- Analysis of treatment delays, streptokinase and aspirin use, risk factors, and pre-hospital care.
Main Results:
- Median delay from chest pain onset to CCU admission was 6 hours.
- 26 of 41 M.I. patients received streptokinase.
- 88% discharged on aspirin, but only 12% on beta-blockers.
- 16/41 M.I. patients had cholesterol > 6 mmol/l; only 12/41 had prior cholesterol checks.
- 36/41 patients saw a GP for chest pain; 18 received analgesics, 13 receiving morphine.
Conclusions:
- Significant delays in CCU admission for M.I. patients were observed.
- While aspirin use at discharge was high, beta-blocker use was low.
- Community-level cardiovascular risk factor screening, particularly cholesterol checks, was inadequate.