Variabilidad en el manejo hospitalario del infarto agudo de miocardio en España. Estudio IBERICA (Investigación, Búsqueda Específica y Registro de Isquemia Coronaria Aguda)

Abstract

Introduction and objective. Although some in-hospital studies have described the management of acute myocardial infarction (MI) patients in Spain, none has been able to guarantee the exhaustiveness of patient registry. This study sought to determine the clinical characteristics and in-hospital management of patients with MI in eight Spanish population registries.Methods. The IBERICA study is a population-based MI registry carried out in the 25 to 74 year-old population, in eight Spanish regions in 1997. A standardized methodology was used to register and investigate all MI arriving alive to a hospital. Clinical characteristics, cardiovascular risk factors prevalence, pharmacological treatment, invasive and non-invasive procedures performed and complications at 28 days of evolution were recorded. A descriptive analysis was performed and the variation coefficient (VC) was calculated.Results. In 1997, 4,041 MI patients were registered, 79.9% were men with a mean age of 61.1 years. Although 10.9% (95% CI: 9.9-11.9%) were not admitted to the coronary care unit, a large variability existed among different areas (VC = 53%). There was a high variability in the utilization and performance of non-invasive and invasive procedures among regions, as well as in the use of pharmacological treatment. Only the use of antiaggregants (91.5%) and thrombolytic therapy (41.8%) showed a low variability (VC < 10%). Twenty-eight day mortality was 16.2% (95% CI: 15.1-17.4%) with a high variability being observed among the different regions (VC = 20.6%).Conclusion. Patient characteristics vary among the different Spanish regions. The differences in management and prognosis suggest a lack of equality in the health care provided to MI patients in the different regions in Spain.

Enfermedades cardiovasculares: problema de salud en las mujeres

“…En España se pueden obtener datos sobre la incidencia de la cardiopatía isquémica del programa MONICA-Cataluña (Sans et al, 2001), del registro REGICOR y del estudio IBERICA (Fiol et al, 2001). Estos estudios indican que la incidencia del IAM, al igual que ocurre con la mortalidad, es más baja que en otros países …”

Myocardial Infarction in the population aged 25-74 in Navarra. Incidence, lethality and treatment in the period 1997-98. IBERICA study

“…El estudio IBERICA se diseñó para monitorizar y comparar las tasas de incidencia, ataque, mortalidad, y la letalidad a los 28 días del infarto agudo de miocardio (IAM), en distintas áreas de 8 comunidades autónomas: Castilla-La Mancha (Toledo y Albacete), Cataluña (Girona), Galicia (A Coruña), Islas Baleares (Mallorca), Valencia, Murcia, Navarra y País Vasco, entre los residentes de 25-74 años. Se utilizaron métodos similares en todas las áreas para detectar los casos y para registrar las características demográficas, clínicas y las complicaciones, incluyendo las muertes en los primeros 28 días tras el inicio de los síntomas 13,14 . Para la detección de los casos de IAM hospitalizados se realizó una búsqueda activa en todos los hospitales, públicos y privados, utilizando como fuentes de información las unidades de cuidados intensivos cardiológicos, servicios de cardiología y listados de altas hospitalarias.…”

Effect of Smoking Status on Healthcare Costs and Resource Utilization in Patients with Type 2 Diabetes in Routine Clinical Practice: A Retrospective Nested Case-Control Economic Study

“…Currently, in Spain, the prevalence of smoking is 35.4% in patients with acute myocardial infarction and about 32% in patients with angina pectoris. Overall, it is estimated that 29% of deaths from coronary heart disease are due to smoking, and 1 in 3 deaths caused by smoking is premature [13,14]. Therefore, smoking increases cardiovascular risk in both diabetics and nondiabetics [15,16].…”

“…Evidence shows that smoking cessation leads to reduced cardiovascular risk [15,16,19]. Studies have shown a reduction in the incidence of CVEs and a decrease in symptoms of arteriosclerotic disease in patients with heart disease who stop smoking [13,15,20]. There is abundant evidence that smoking in diabetic patients is associated with a worse prognosis and acceleration of vascular complications and that cessation provides early benefits [20,21].…”