Population-based register of acute myocardial infarction: manual of operations

Abstract

Cardiovascular disease is the leading cause of death and hospitalization in both sexes in nearly all countries of Europe. The main forms of cardiovascular disease are ischaemic heart disease and stroke. The magnitude of the problem contrasts with the shortage, weak quality and comparability of data available in most European countries. Innovations in medical, invasive and biological treatments have substantially contributed to the escalating costs of health services. It is therefore urgent to obtain reliable information on the magnitude and distribution of the disease for both adequate health planning (including preventive strategies) and clinical decision making with correct cost-benefit assessments.A stepwise surveillance procedure based on standardized data collection, appropriate record linkage and validation methods was set up by the EUROCISS Project (EUROpean Cardiovascular Indicators Surveillance Set) to build up comparable and reliable indicators (attack rate and case fatality) for the surveillance of acute myocardial infarction/acute coronary syndrome at population level. This manual of operations is intended for health professionals and policy makers and provides a standardized and simple model for the implementation of a population-based register. It recommends to start from a minimum data set and then follow a stepwise procedure. Before implementing a population-based register, it is important to identify the target population under surveillance which should preferably cover a well-defined geographical and administrative area or region representative of the whole country for which population data and vital statistics (mortality and hospital discharge records at minimum) are routinely collected and easily available each year. All cases among residents should be recorded even if the case occurs outside the area. Validation of a sample of fatal and nonfatal events is mandatory.

Impact of a nationwide public campaign on delays and outcome in Swiss patients with acute coronary syndrome

“…Cardiovascular disease is a major cause of morbidity and mortality, 1 accounting for 40% of deaths in Switzerland. 2 The time between onset of symptoms and beginning treatment has a critical impact on morbidity and outcome in patients with acute coronary syndrome (ACS) and acute myocardial infarction (AMI).…”

“…We report on a prospective outcome evaluation of a nationwide public campaign of the Swiss Heart Foundation ('HELP campaign') by using the nationwide AMIS (Acute Myocardial Infarction in Switzerland) Plus patient registry. 14 To improve the final outcome of patients with ACS, the HELP campaign had three aims: (1) to improve knowledge and awareness of early symptoms of acute myocardial infarction (ischaemic pain and severe dyspnoea), (2) to speed up patient access to emergency medical services using a uniform phone number, and (3) to propagate skills for resuscitation and basic life support to the public.…”

Development of the Andalusian Registry of Patients Receiving Community Case Management, for the follow‐up of people with complex chronic diseases

“…The existence of a clinical registry of patients with complex chronic diseases who receive case management is an important innovation not only in the PHCSA, but also at an international level. At present, there are registries for selected chronic conditions such as diabetes [37,38], stroke [39], heart disease [40], asthma [41]or the attempt to obtain the prevalence and incidence of chronic diseases from usual clinical records [42], but not in the case of multimorbid patients with multiple conditions who receive case management. This novel approach will permit a complete and in‐depth analysis of the characteristics of the patients who receive this service, the interventions delivered and some major outcomes as mortality, readmissions, or adverse events.…”

Cardiovascular diseases monitoring: lessons from population-based registries to address future opportunities and challenges in Europe

“…AMI incidence/attack rate, case fatality and prevalence were suggested for inclusion in the European Community Health Indicators (ECHI) short list (n.24 and 25) [ 16 ]. A second phase of the EUROCISS Project (2004–2007) was launched aiming at (a) developing knowledge, tools and expertise among Member States for CVD surveillance and prevention; (b) preparing the Manual of Operations for the implementation of a population-based registry of AMI/acute coronary syndrome (AMI/ACS) [ 17 ], of stroke [ 18 ], and of CVD surveys for assessing standardized indicators (prevalence of old myocardial infarction, heart failure, late effects of cerebrovascular diseases, and other CVD), and for identifying a minimum set of questions and exams to be included in the Health Examination Survey (HES) for evaluating the prevalence of CVD at European level [ 19 ]. The EUROCISS project provided recommendations to assess reliable and comparable indicators, methodologies for validating suspected cases and for classifying events, and suggested a stepwise procedure to assess the indicators proposed and recommended for the ECHI list.…”