[The registries of myocardial infarction: an opportunity for improvement. The PREVESE II Study].
نویسنده
چکیده
In recent decades there has been a decline in mortality due to cardiovascular disease, including the mortality due to ischemic heart disease. Diverse clinical trials have demonstrated the effectiveness of aspirin, beta-blockers, and angiotensin-converting enzyme inhibitors, as well as lipid-lowering agents, especially the statins, in patients who have suffered a myocardial infarction (MI), although there have been few clinical trials of the statins in the acute phase. Nevertheless, secondary prevention is based not only on pharmacological treatment; the habits of patients with infarction are also important. Consequently, smoking cessation, changes in eating habits , and the prescription of regular physical activity are also effective and unquestionably useful measures. In fact, they are listed (type I and IIa recommendations) in the guidelines for clinical action of the Spanish Society of Cardiology. 1 The PREVESE II study 2 published in this number of REVISTA ESPAÑOLA DE CARDIOLOGÍA contributes interesting data on the situation of secondary prevention of MI in Spain and the degree to which the measures described above were applied in 1998. In addition, it compares results with a similar registry made 4 years by the same investigators. The authors emphasize that secondary prevention has improved, particularly with respect to the prescription of cardioprotective drugs at the time of hospital discharge. Thus, in the 1994-98 period the prescription of beta-blockers increased from 33.3% to 45.1%, angiotensin-converting enzyme inhi-bitors from 32.5% to 46.4%, and statins from 4.5% to 29.4%. In spite of this, comparison with similar studies shows that is still room for improvement, even in pharmacological treatment, as it is indicated in the discussion of the article. Nevertheless, analysis of the study suggests several commentaries on the methodology of registries and the interpretation and application of their results. The proliferation of MI registries in Spain reflects their usefulness. Spanish hospitals participate in regional registries like PRIMVAC, 3 national registries like RISCI, 4 and supranational registries. 5,6 Therefore, instead of emphasizing the advantages and possibilities that registries and databases offer, it seems more suitable to reflect on methodological aspects that can enhance or lessen the validity of results. 7 In the first place, the extent to which a registry adequately represents the population analyzed should be considered. To this end, not only is the number of patients included important, but the selection of participating centers is fundamental, as well as avoiding possible biases in the inclusion of patients from each hospital. The …
منابع مشابه
[New data on secondary prevention of myocardial infarction in Spain. Results of the PREVESE II study].
Introduction and objectives. The PREVESE Study reported the situation of secondary prevention after myocardial infarction in Spain. Similar surveys conducted in Europe have also shown that the implementation of secondary prevention is not adequate. The aim of this second PREVESE study was to compare the situation in Spain four years after the first study.Patients and method. We included retrosp...
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ورودعنوان ژورنال:
- Revista espanola de cardiologia
دوره 55 8 شماره
صفحات -
تاریخ انتشار 2002