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[EPIM. Survey of myocardial infarction in Picardie]
G Jarry1, J L Richard, J S Hermida
1Service de réanimation et de cardiologie A, hôpital Sud, Amiens.
Insights
This study found a high mortality rate of 22.3% for recent myocardial infarction patients in Picardy. Delays in hospital admission and underutilization of key treatments like thrombolytics were noted.
Area of Science:
- Cardiology
- Epidemiology
Background:
- Myocardial infarction (MI) remains a leading cause of mortality worldwide.
- Understanding regional incidence, management, and outcomes is crucial for improving patient care.
Purpose of the Study:
- To determine the incidence and outcomes of recent myocardial infarction (MI) in the Picardy region.
- To assess pre-hospital delays, management strategies, and acute treatment protocols for MI patients.
- To evaluate the utilization of exercise stress testing and coronary angiography in MI management.
Main Methods:
- Prospective study conducted in Aisne, Oise, and Somme departments from October 1985 to September 1986.
- Data collected from 1260 hospitalized patients with recent myocardial infarction via questionnaires.
- Analysis of patient demographics, time to admission, transport methods, hospital management, and treatments received.
Main Results:
- A total of 1260 MI cases were analyzed, with an average patient age of 66.7 years.
- Significant pre-hospital delay was observed (16.6 +/- 47.5 hours), with two-thirds of patients using non-medicalized transport.
- Acute phase treatments included Heparin (94%), nitrates (93.7%), and calcium inhibitors (78%), while thrombolytics (8.3%) and beta-blockers (23.5%) were underutilized.
- The in-hospital mortality rate was 22.3% over an average hospital stay of 17 days.
Conclusions:
- The study highlights substantial delays in hospital admission and suboptimal use of evidence-based therapies for myocardial infarction in the region.
- The high in-hospital mortality rate underscores the need for improved emergency response and treatment protocols.
- Further investigation into barriers to timely and effective MI management is warranted.
Abstract:
The aim of this prospective study carried out in picardy (Aisne, Oise and Somme Departments) between October 1st 1985 and September 30th 1986, was to determine the incidence and outcome of recent myocardial infarction (less than 1 month) hospitalised in the region, to assess the time delay before hospital admission, the mode of management, treatment in the acute phase and at discharge, and the attitudes to exercise stress testing and coronary angiography. All public and private hospitals of the 3 departments who admitted patients with acute myocardial infarction accepted to fill out the questionnaire. A total of 1260 infarcts in patients with an average age of 66.7 +/- 12.6 years were collected. Nearly 3 out of 4 patients were male, and the men generally 10 years younger (64 +/- 12.6 years) than the women (73.4 +/- 10 years). The time delay to hospital admission was very long: 16.6 +/- 47.5 hours. Two thirds of patients were transferred by non medicalised transport; 82 per cent of patients were directed to the casualty department which redirected 71 per cent to the cardiology department. Myocardial infarction was inaugural in 46.5 per cent of cases. The incidence of anterior and inferior infarction was almost identical (44 ans 45.5 per cent respectively). Treatment in the acute phase included Heparin (94 per cent), nitrate derivatives (93.7 per cent) and calcium inhibitors (78 per cent). Thrombolytic and betablocker therapy was only prescribed in 8.3 and 23.5 per cent of cases respectively. During the hospital period, average 17 +/- 9 days, the mortality rate was 22.3 per cent.(ABSTRACT TRUNCATED AT 250 WORDS)