Epidemiology of Acute Myorcardial Infarction in Public Hospitals of Buenos Aires City

pp 201- 207

Abstract

Objectives

To analize the clinical characteristics and evolution of patients with an acute myocardial infarction (AMI) admitted to public hospitals in Buenos Aires city.

Methods

Five hundred and nine consecutive patients admit-ted to coronary care or intensive care units of eleven public hospitals belonging to the Government of Buenos Aires city between January 1997 and December 1997 were included in a prospective observational study.

Results

Mean age for whole population was 58.12 ± 9.5 years. Mean age of the 86 women was 66.7 ± 13.14 years and that for the 423 men was 56.4 ± 10.8 years. Fifty two per cent of the population had a history of hypertension, 18% were diabetics,33% had dyslipidemia and 55%were smokers. Eighty six patients had previous infarction and 202 had a his-tory of angina. Twenty four per cent of the population developed a non-Q wave myocardial infarction. Infarct location was anterior in 50% and inferior in 45% of the cases. Killip class at admission was I in 80%,II in 15%,III in 4%and IV in2% of the population. During in-hospital stay 16% developed postinfarction angina and 6% reinfarction. Thrombolytic treatment was given to 48%,91% received aspirin, 13% intravenous beta blockers, 62% oral beta blockers and 92% nitrates. Within one month 77% had an echocardiogram performed, 23%an exercise stress test, 19% a coronary angiography, 7% a radionucleide study and 3% a Holter monitoring. Coronary angioplasty was performed to only 6 patients and only one patient underwent bypass surgery. In-hospitalmortality was 8%.Clinical variables related to mortality in the multivariate analysis were age, heart failure and non-Qwave infarction.

Conclusions

Patients admitted to public hospitals with an acute myocardial infarction have: a) low prevalence of women; b) reduced indication of coronary angiography, exercise stress tests and Holter monitoring, c) very low performance of angioplasty and coronary surgery, d) low mortality.