Resultados Chilenos del registro internacional de factores de riesgo y tratamiento de angina inestable e infarto al miocardio sin supradesnivel del segmento ST: ACCORD (ACute CORonary syndrome Descriptive study) / Chilean results of the international registry of risk factors and treatment of unstable angina and non ST elevation myocardial infarction: ACCORD (ACute CORonary syndrome Descriptive study)
Rev. méd. Chile
;
139(1): 19-26, ene. 2011. ilus
Article
in Spanish
| LILACS
| ID: lil-595261
ABSTRACT
Background:
Guidelines for the management of unstable angina (UA) and non ST elevation myocardial infarction (NSTEMI) have been issued, however cu-rrent practices are unknown in Chile. Aitn To evalúate in a prospective cohort of NSTEMI patients the current practices, treatments and risk factors. Material andMethods:
Oneyear prospective International non interventional registry, conducted in Chile between January 2005 and November 2006.Results:
Two hundred thirty three Chilean NSTEMI patients were enrolled. Mortality was 5.5 percent at the end ofthe follow-up. Mean age was 61.6 years, and 30.6 percent were female. Most of the patients had at least one risk factor (98 percent) hypertension (84 percent), previous myocardial infarction (33 percent), dyslipidemia (54 percent), diabetes (33 percent), current smoking (30 percent). Main procedures duringthe hospitalization were coronary angiogram (67 percent), angioplasty (33 percent; 88 percent with stent) and coronary bypass surgery (7 percent). Duringprocedures, 31 percent of patients received clopidogrel, and 4.2 percent glycoprotein Ilb/IIIa antagonists. Medical management was selected for 60 percent of patients. In comparison to men, women received less interventional procedures despite havingmore risk factors. Treatments prescribed at discharge were aspirin (97 percent), clopidogrel (49 percent), beta blockers (78 percent), diuretics (21 percent), lipid lowering agents (78 percent), oral hypoglycemic agents (13 percent) and insulin (9 percent). At the end ofthe 1-year follow-up, treatments were aspirin (84 percent), beta blockers (72 percent), diuretics (19 percent), and dual antiplatelet therapy with clopidogrel (16 percent).Conclusions:
A high prevalence of múltiple risk factors for cardiovascular disease in Chilean patients with NSTEMI was observed. More aggressive primary and secondary preventive measures are urgently needed. Use of therapies proposed in the guidelines is high, but dual antiplatelet therapy is less than 50 percent at discharge and decreases during the one year-follow-up.
Full text:
Available
Index:
LILACS (Americas)
Main subject:
Patient Discharge
/
Practice Guidelines as Topic
/
Guideline Adherence
/
Hospitalization
/
Angina, Unstable
/
Myocardial Infarction
Type of study:
Etiology study
/
Practice guideline
/
Observational study
/
Prognostic study
/
Risk factors
Limits:
Female
/
Humans
/
Male
Country/Region as subject:
South America
/
Chile
Language:
Spanish
Journal:
Rev. méd. Chile
Journal subject:
Medicine
Year:
2011
Type:
Article
Affiliation country:
Chile
Institution/Affiliation country:
Clínica Dávila/CL
/
Hospital Barros Luco-Trudeau/CL
/
Hospital Clínico, Pontificia Universidad Católica de Chile/CL
/
Universidad de La Frontera+CL
/
Hospital Higueras/CL
/
Hospital Regional de Rancagua/CL
/
Hospital San Borja-Arriarán/CL
/
Hospital San Juan de Dios/CL
/
Hospital de Urgencias Posta Central/CL
/
Hospital del Salvador/CL
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