Increasing myocardial infarction mortality trends in a middle-income country

Balda-Canizares, Javier A.; Tamariz, Leonardo; Moreno-Zambrano, Daniel; Pareja, Denisse; Ortíz-Prado, Esteban; Palacio, Alfredo; Palacio, Ana

doi:10.21037/cdt.2018.07.03

Cited by 2 publications

(3 citation statements)

References 11 publications

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“…In a previous study among Amerindians in Ecuador, a low prevalence of atrial fibrillation was found, which can be explained by, both, “racially determined short stature and frequent dietary oily fish intake.” 38 The most significant predictors of the increasing mortality rate from myocardial infarction in Ecuador were living in the coast belonging to a mixed race. 16 The Montubio (“an aboriginal mestizo group that originates from the coastal part of Ecuador”) 18 may form part of this mortality rate from myocardial infarction. In the study among older adults in Ecuador, 4 people living on the coast had an increased risk of heart disease and stroke compared to those in the highlands.…”

Section: Discussionmentioning

confidence: 99%

“… 13 , 14 CVDs contribute to 24% of mortality in 2016 in Ecuador. 15 Using the mortality national registry in Ecuador, the myocardial infarction mortality rate increased from 51 in 2012 to 157 in 2016 deaths per 100,000, 16 and mortality due to ischemic heart disease increased in Ecuador in the period 2001–2016. 17 Ecuador’s population (16.9 million) consists of a mixture various ethnic groups, ranging from Mestizo (71.9%) to Afro Ecuadorian (4.3%).…”

Section: Introductionmentioning

confidence: 99%

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Prevalence and Correlates of Self-Reported Cardiovascular Diseases Among a Nationally Representative Population-Based Sample of Adults in Ecuador in 2018

Pengpid¹,

Peltzer²

2021

VHRM

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Background This study aimed to determine the prevalence and correlates of self-reported cardiovascular diseases (SRCVDs) among adults in Ecuador. Methods National cross-sectional survey data of 4638 persons aged 18–69 years in Ecuador were analysed. Research data were collected with an interview-administered questionnaire, physical and biochemical measurements. Results The prevalence of SRCVDs was 8.7%, 8.5% among men and 8.9% among women. In adjusted logistic regression analysis, being Montubio (adjusted odds ratio-AOR: 1.66, 95% confidence interval-CI: 1.10–2.50), family alcohol problems (AOR: 1.78, 95% CI: 1.19–2.65), past smoking tobacco (AOR: 1.36, 95% CI: 1.02–1.81), and poor oral health status (AOR: 1.74, 95% CI: 1.19–2.54) were associated with SRCVD. In addition, in unadjusted analysis, older age, alcohol dependence, obesity, and having hypertension were associated with SRCVD. Conclusion Almost one in ten persons aged 18–69 years had SRCVD in Ecuador. Several associated factors, including Montubio by ethnicity, family alcohol problems, past smoking, and poor oral health status, were identified, which can be targeted in public health interventions.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Prevalence and Correlates of Self-Reported Cardiovascular Diseases Among a Nationally Representative Population-Based Sample of Adults in Ecuador in 2018

Pengpid¹,

Peltzer²

2021

VHRM

View full text Add to dashboard Cite

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“…The mortality rate from IHD is slowly trending down in most high-income countries with advancements in the acute management of acute coronary syndromes (ACS) such as coronary revascularization, primary and secondary preventive measures after myocardial infarction and better treatment of IHD risk factors [ 2 , 3 ]. However, IHD mortality rate in low and middle-income countries (LMICs) are sharply increasing as a result of an increase in cardiovascular risk factors and globalization [ 4 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

Management quality indicators and in-hospital mortality among acute coronary syndrome patients admitted to tertiary hospitals in Ethiopia: prospective observational study

et al. 2021

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Background Acute coronary syndrome (ACS) remains the leading cause of cardiovascular disease mortality and morbidity worldwide. While the management quality measures and clinical outcomes of patients with ACS have been evaluated widely in developed countries, inadequate data are available from sub-Saharan Africa countries. So, this study aimed to assess the clinical profiles, management quality indicators, and in-hospital outcomes of patients with ACS in Ethiopia. Methods A Prospective observational study was conducted at two tertiary hospitals in Ethiopia from March 2018 to November 2018. The primary outcome of the study was in-hospital mortality. Data were analyzed using SPSS version 23.0. Multivariable cox-regression was conducted to identify predictors of time to in-hospital mortality. Variable with p -value < 0.05 was considered statistically significant. Results Among 181 ACS patients enrolled, about (61%) were presented with ST-elevation myocardial infarction (STEMI). The mean age of the study participant was 55.8 ± 11.9 years and 62.4% were males. The use of guideline-directed medications within 24 h of hospitalization were sub-optimal (57%) [Dual antiplatelet (73%), statin (74%), beta-blocker (67%) and ACEI (61%)]. Only (7%) ACS patients received the percutaneous coronary intervention (PCI). Discharge aspirin and statin were high (> 90%) while other medications were sub-optimal (< 80%). The all-cause in-hospital mortality rate was 20.4% and the non-fatal MACE rate was 25%. Rural residence (AHR: 3.64, 95% CI: 1.81–7.29), symptom onset to hospital arrival > 12 h (AHR: 4.23, 95% CI: 1.28–13.81), and Cardiogenic shock (AHR: 7.20, 95% CI: 3.55–14.55) were independent predictors of time to in-hospital death among ACS patients. Conclusion In the present study, the use of guideline-directed in-hospital medications was sub-optimal. The overall in-hospital mortality rate was unacceptably high and highlights the urgent need for national quality-improvement focusing on timely initiation of evidence-based medications, reperfusion therapy, and strategies to reduce pre-hospital delay.

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Increasing myocardial infarction mortality trends in a middle-income country

Cited by 2 publications

References 11 publications

Prevalence and Correlates of Self-Reported Cardiovascular Diseases Among a Nationally Representative Population-Based Sample of Adults in Ecuador in 2018

Prevalence and Correlates of Self-Reported Cardiovascular Diseases Among a Nationally Representative Population-Based Sample of Adults in Ecuador in 2018

Management quality indicators and in-hospital mortality among acute coronary syndrome patients admitted to tertiary hospitals in Ethiopia: prospective observational study

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