Acute Myocardial Infarction Incidence, Mortality and Case Fatality in Santa Clara, Cuba, 2007–2008

INTRODUCTION Information on acute myocardial infarction incidence and mortality is essential for determining the ef¿cacy of the health systems cardiovascular disease prevention activities; however, in Cuba, suf¿cient data related to acute myocardial infarction are lacking, particularly at the local level. OBJECTIVE Describe acute myocardial infarction incidence, mortality and case fatality rates from January 2007 through December 2008in persons aged 45-74 in the municipality of Santa Clara, Villa ClaraProvince, Cuba. METHODS A retrospective descriptive study was conducted. The World Health Organization MONItoring Trends and Determinants in CArdiovascular Disease Project (MONICA) methodology was used, but only in part, since out-of-hospital case fatalities were not investigated, resulting in insuficient data for such cases. Cases ofacute myocardial infarction covered under MONICA definition 1 were included (non-fatal de¿nite, fatal definite, fatal possible, andunclassifiable deaths). Hospitalized patients were followed for 28 days. Incidence, mortality and case fatality rates in the population were calculated by age group (45–54, 55–64 and 65–74 years) and sex. Age-standardized incidence and mortality rates were calculated using the direct method, with the world population as a reference(AU)

Registro hospitalario de infarto agudo de miocardio en Santa Clara 2007-2008 / Hospital registry of acute miocardial infarction in Santa Clara

Introduction and objectives: In Cuba, the vital statistics of morbi-mortality due to acute myocardial infarction come from small health areas. The objective of this study was to identify the main characteristics and hospital management of patients with myocardial infarction, through a hospital registry of infarctions. Methods: The cases of acute myocardial infarction in patients between 45 and 74 years of age, from Santa Clara, during 2007 and 2008, were monitored. The information sources were: hospital discharge records, hospital registry of myocardial infarction, death certificates and nosocomial autopsy records. The MONICA methodology was used (Monitoring Trends and Determinants in Cardiovascular Disease Project). Results: a total of 297 patients with acute myocardial infarction were registered; 62,7 percent of males and 46,8 percent of women received reperfusion treatment. The hospital deaths in males and women were 25,3 percent and 45 percent respectively. The variables related to a higher mortality were: age, female sex, a high cardiac frequency, anterior-wall infarction, a high creatinine level, as well as individual antecedents of ischemic heart disease and diabetes mellitus. On the other hand, the treatments with fibrinolitics and/or beta-blockers were inversely proportional to mortality. Conclusions: There was a high prevalence of unknown dyslipidemia and hospital death within 28 days; as well as little use of invasive strategies. Systolic hypertension at the time of admission was related with a better prognosis(AU)