Determinants of treatment strategies and survival in acute myocardial infarction: a population-based study in the Florence district, Italy Results of the acute myocardial infarction Florence registry (AMI-Florence),,

Buiatti, Eva; Barchielli, Alessandro; Marchionni, Niccolò; Balzi, Daniela; Carrabba, Nazario; Valente, Serafina; Olivotto, Iacopo; Landini, Cristina; Filice, Maurizio; Torri, Marco; Regoli, G; Santoro, Giovanni Maria

doi:10.1016/s0195-668x(03)00207-0

Cited by 49 publications

(58 citation statements)

References 23 publications

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“…[41] Clearly, all phases of intervention need to be considered to address the problem of AMI mortality: notwithstanding improvements in AMI treatment and serious efforts at primary prevention, AMI continues to cause millions of deaths worldwide. [3,42,43] In our study, as in other countries, men had higher AMI mortality rates then women, a pattern similar to that of Despite declining mortality rates, absolute numbers of AMI deaths continue to rise because of population aging, one of the most signifi cant demographic and social consequences of declining fertility and increased life expectancy. [12,22] We found that AMI mortality rates increased with age, independent of sex, which may be explained in part by its association with atherosclerosis and numerous age-related risk factors.…”

Section: Discussionsupporting

confidence: 84%

Acute myocardial infarction mortality in Cuba, 1999-2008

Armas¹,

Ortega²,

Noval³

et al. 2012

MEDICC rev.

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INTRODUCTION Acute myocardial infarction is one of the leading causes of death in the world. This is also true in Cuba, where no national-level epidemiologic studies of related mortality have been published in recent years.OBJECTIVE Describe acute myocardial infarction mortality in Cuba from 1999 through 2008.METHODS A descriptive study was conducted of persons aged ≥25 years with a diagnosis of acute myocardial infarction from 1999 through 2008. Data were obtained from the Ministry of Public Health's National Statistics Division database for variables: age; sex; site (out of hospital, in hospital or in hospital emergency room) and location (jurisdiction) of death. Proportions, age-and sex-specifi c rates and age-standardized overall rates per 100,000 population were calculated and compared over time, using the two fi ve-year time frames within the study period.RESULTS A total of 145,808 persons who had suffered acute myocardial infarction were recorded, 75,512 of whom died, for a case-fatality rate of 51. 8% (55.1% in 1999-2003 and 49.7% in 2004-2008). In the fi rst fi ve-year period, mortality was 98.9 per 100,000 population, falling to 81.8 per 100,000 in the second; most affected were people aged ≥75 years and men. Of Cuba's 14 provinces and special municipality, Havana, Havana City and Camagüey provinces, and the Isle of Youth Special Municipality showed the highest mortality; Holguín, Ciego de Ávila and Granma provinces the lowest. Out-of-hospital deaths accounted for the greatest proportion of deaths in both fi ve-year periods (54.8% and 59.2% in 1999-2003 and 2004-2008, respectively).CONCLUSIONS Although risk of death from acute myocardial infarction decreased through the study period, it remains a major health problem in Cuba. A national acute myocardial infarction case registry is needed. Also required is further research to help elucidate possible causes of Cuba's high acute myocardial infarction mortality: cardiovascular risk studies, studies of out-of-hospital mortality and quality of care assessments for these patients.

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Section: Discussionsupporting

confidence: 84%

Acute myocardial infarction mortality in Cuba, 1999-2008

Armas¹,

Ortega²,

Noval³

et al. 2012

MEDICC rev.

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“…Before admission, all patients had undergone primary PCI, which is the only reperfusion strategy for STEMI at Azienda OspedalieroUniversitaria Careggi, with no age restriction. [8][9][10] Inclusion criteria for direct primary PCI were: chest pain ≥30 min with ST-segment elevation on ECG ≥0.1 mV in ≥2 con-…”

Section: Methodsmentioning

confidence: 99%

Effectiveness and Safety of Routine Primary Angioplasty in Patients Aged .GEQ.85 Years With Acute Myocardial Infarction

Valente

Lazzeri

Salvadori

et al. 2008

Circ J

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“…Regarding cardiac emergencies, Careggi hospital is also the referring center for four community hospitals (the furthest being 50 km away from Careggi), located in the so-called area Vasta. In our hospital, in Florence, the reperfusion strategy of STEMI patients is represented by primary PCI [16][17][18]. STEMI patients are first evaluated by the Medical Emergency System staff in the pre-hospital setting and then directly admitted to the catheterization laboratory or transferred to it after a rapid stabilization in the first aid.…”

Section: Study Populationmentioning

confidence: 99%

The glucose dysmetabolism in the acute phase of non-diabetic ST-elevation myocardial infarction: from insulin resistance to hyperglycemia

et al. 2011

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In the setting of acute myocardial infarction, hyperglycemia and acute insulin resistance may represent a stress response to myocardial injury mainly related to acute catecholamine release. By measuring glucose values and insulin resistance (Homeostatic Model Assessment index-HOMA), we evaluated in 356 non-diabetic patients with STelevation myocardial infarction (STEMI) undergone mechanical revascularization: (a) the acute glycometabolic response by evaluating insulin resistance, glucose levels, and their combination and (b) whether insulin resistance and increased glucose values (and their combination) are able to affect in-Intensive Cardiac Care Unit (ICCU) mortality and complications. In the overall population, 226 (63.5%) patients showed glucose values B140 mg/dl (group B), while 130 patients had glucose values[140 mg/dl (group A) (36.5%). Within group B, insulin resistance (as inferred by positive HOMA index) was present in 125 patients (55.3%), whereas 101 patients (44.7%) exhibited normal values of HOMA index. Within group A, 109 patients (83.8%) were insulin resistant, while 21 patients (16.2%) had normal values of HOMA index. At multivariable analysis, glucose values were independently associated with in-ICCU mortality (OR: 7.387; 95% CI 2.701-20.201; P \ 0.001) and complications (OR: 1.786; 95% CI 1.089-2.928; P = 0.022). In the early phase of STEMI, the acute glycometabolic response to stress is heterogeneous (ranging from no insulin resistance to glucose levels[140 mg/dl and, finally, to the combination of increased glucose values and insulin resistance). Increased glucose values are stronger prognostic factors since they are independently associated with in-ICCU mortality and complications.

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Determinants of treatment strategies and survival in acute myocardial infarction: a population-based study in the Florence district, Italy Results of the acute myocardial infarction Florence registry (AMI-Florence),,

Cited by 49 publications

References 23 publications

Acute myocardial infarction mortality in Cuba, 1999-2008

Acute myocardial infarction mortality in Cuba, 1999-2008

Effectiveness and Safety of Routine Primary Angioplasty in Patients Aged .GEQ.85 Years With Acute Myocardial Infarction

The glucose dysmetabolism in the acute phase of non-diabetic ST-elevation myocardial infarction: from insulin resistance to hyperglycemia

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