Trends in the Use of Evidence-based Therapies Early in the Course of Acute Myocardial Infarction and its Influence on Short Term Patient Outcomes

نویسندگان

  • Mohammad Al-Jarallah
  • Mouaz H Al-Mallah
  • Mohammad Zubaid
  • Alawi A Alsheikh-Ali
  • Wafa Rashed
  • Mustafa Ridha
  • Fahad Alenizi
  • Bassam Bulbanat
  • Mousa Akbar
  • Rashed Al-Hamdan
  • Shahid Zubair
چکیده

AIM To evaluate changes in management practices and its influence on short term hospital outcomes in patients with acute myocardial infarction (AMI) admitted during two different time periods, 2007 and 2004. METHODS AND RESULTS We studied AMI patients from two acute coronary syndrome registries carried out in Kuwait in 2007 and 2004. We included 1872 and 1197 patients from the 2007 and 2004 registries, respectively. When compared with 2004, patients from the 2007 registry had similar baseline clinical characteristics. In 2007 compared to 2004, during the in-hospital period, patients with AMI received significantly more statins (94% vs. 73%%, p<0.0001), Angiotensin converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARB) (70% vs. 47%, p<0.001), and Clopidogrel (38% vs. 4%, p<0.001), while beta-blockers use dropped in 2007 compared to 2004 (63% vs. 68%, p=0.0066). The rates of in-hospital mortality and recurrent ischemia were significantly lower in the 2007 cohort compared with the 2004 cohort (for mortality 2.2% vs. 3.9%, P=0.0008, for recurrent ischemia 13.7% vs. 20.4%, P=0<0.0001).Higher utilization of angiotensin converting enzyme inhibitors, angiotensin receptor blockers and statins were the main contributors to the improved in-hospital mortality and morbidity. IN CONCLUSION In the acute management of AMI, there was a significant increase in the use of statins, ACE inhibitors and Clopidogrel in 2007 compared to 2004. This was associated with a significant decrease in the in-hospital mortality and recurrent ischemia. Adherence to guidelines recommended therapies improved in-hospital outcomes.

برای دانلود رایگان متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Prediction of long-term cardiac events by 123I-MIBG imaging after acute myocardial infarction and reperfusion therapy

Objective(s): In heart failure, the heart-to-mediastinum (H/M) ratio of the delayed image and washout rate (WR) are well-known as a powerful cardiac event predictors. H/M ratio quantifies the accumulation rate of MIBG in the myocardium and WR quantifies reduction of meta-iodobenzylguanidine (MIBG) accumulation in the heart from the early planar image to the delayed pla...

متن کامل

Myocardial damage of the entire ventricular region in a patient with acute myocardial infarction

Technetium-99m-pyrophosphate (99mTc-PYP) has been used, in combination with thallium-201, to estimate the site and extent of myocardial infarcts. We report a case of acute myocardial infarction with severe coronary disease in which the distribution of 99mTc-PYP was extensive. A 78-year-old man presented with dyspnea, and a diagnosis of non-ST-segment elevation acute myocar...

متن کامل

Acute Myocardial Infarction in a 17-Year-Old Boy Secondary to Lightning Strike

Although lightning is an uncommon phenomenon in nature; it can cause many destructive incidents. In the event of a lightning strike, multiple organs particularly the cardiovascular systems are at risk of injury. Short-term mortality depends on its cardiac effects. In this paper, the authors report the development of myocardial infarction and pericardial effusion after lightning injury, a typica...

متن کامل

Study of the Duration, Outcomes, and Related Factors of Reperfusion Therapy in Patients with ST-Segment Elevation Myocardial Infarction

Background and Objective: One of the most important advancements regarding the care of patients with acute myocardial infarction is the administration of anti-coagulation medicines (e.g., streptokinase). However, it must be noticed that this medicine requires rapid and timely administration. Moreover, Percutaneous Coronary Intervention (PCI) is increasingly used as a method of revascularization...

متن کامل

بررسی میزان بقای کوتاه مدت بیماران مبتلا به انفارکتوس قلبی حاد و اختلاف آن بین دو جنس در شهرهای اصفهان و نجف آباد در طی سالهای 1378 تا 1387

  Background: The purpose of this study is detecting short-term survival of all hospitalized patients with acute myocardial infarction in Isfahan and Najaf Abad based on sex.   Methods: The data of all patients who were hospitalized with acute myocardial infarction between 1378 to 1387 in Isfahan and Najaf Abad were collected by trained nurses of the surveillance department in a research center...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

عنوان ژورنال:

دوره 5  شماره 

صفحات  -

تاریخ انتشار 2011