Acute Myocardial Infarction in Argentina. SAC Survey 1996

pp. 63-72

Abstract

Objective

To analyze the clinical and epidemiological aspects of acute myocardial infarction (AMI) in Argentina, and adopted strategies.

Method

113 CCU nation wide were surveyed to record all AMI admitted during a period of one month.

Results

A total of 645 patients were included, age 62 ± 13 years, 25% women (age 70 ±12 years vs 59 ±12 years in men; p < 0.01).Risk factors:hypertension 60%; dislipidemia 30%; smoking 48%; diabetes 20%. Clinical antecedents: infarction 15%; revascularization 6.1%; heart failure 4%; angina 20%. Previous medication: AAS, 28.5%; calcium blockers, 15.4%; ACE inhibitors, 17.9%; lipid lowering drugs, 2.9% and estrogen 0.6%. Killip class at admission was: A, 72%; B, 16.9%; C, 3.9%; D, 6.6%. EKG: 79% of patients presented an entry ST segment elevation, 10% ST depression, 6% T wave changes and 5% other non specific changes. In the evolution, 75% of cases were Q wave AMI, non Q wave with T wave inversion 11%, ST depression 7.8% and undetermined 6%. Treatment: 41% of patients received thrombolitics, 91,5% AAS, 37% heparin, 8% intravenous beta blockers, 55% oral beta blockers, 7.5% calcium blockers, ACE inhibitors45.2%, coronary angiography 30.5%, coronary by pass surgery 2.5%, direct angioplasty 7.9%, rescue angioplasty 2.6%.Mortality:at CCU 9.9% and at general guard 0.9%. Overall mortality: 69/645 (10.8%). Reinfarction was observed in 2.6% of patients.

Conclusion

SAC Survey defines the present profile of AMI in our country: it points out the older age of women, a high prevalence of smoking and a low prescription of lipid lowering drugs. Strategies of reperfusion are used in 41% of cases and mortality remains around 10%. There is also a wide use of ACE inhibitors and beta blockers and a low use of calcium antagonists.