Relationship of Therapeutic Improvements and 28-Day Case Fatality in Patients Hospitalized With Acute Myocardial Infarction Between 1978 and 1993 in the REGICOR Study, Gerona, Spain

Abstract

Our results strongly suggest that new therapies introduced since 1986 have contributed to the decrease in 28-day case fatality of patients admitted with a first Q-wave AMI. This decrease could be attributable mainly to the use of antiplatelet and thrombolytic drugs. These findings should encourage the routine use of thrombolytic and antiplatelet drugs and particularly their combination in the acute phase of AMI.

Long-term prognosis after hospital admission for acute myocardial infarction from 1987 to 2006

“…Results from other studies, which also used administrative data, showed a similar improvement in case fatality rates [7,[10][11][12][13][14][15][16]. In a study from Spain 28-day case fatality decreased from 18.3% to 11.4% in both men and women aged 25-74 years during the period 1978-1993 [13].…”

“…In a study from Spain 28-day case fatality decreased from 18.3% to 11.4% in both men and women aged 25-74 years during the period 1978-1993 [13]. Similar decreases were noted in Sweden and Denmark during the period 1987-1999 [11].…”

Efectos de la edad, el periodo de defunción y la cohorte de nacimiento en la mortalidad por enfermedad isquémica del corazón en el sur de España

“…Ademá s, en 1997 hubo una amplia implementació n de unidades de rehabilitació n cardiaca que contribuyeron a mejorar la calidad de vida y la supervivencia. Esto, junto con la generalizació n de la angioplastia despué s de 1998, se asoció a una posterior reducció n de la mortalidad por infarto agudo de miocardio 28,53,54 . Aproximadamente en el año 2000, la Consejería de Salud de la Junta de Andalucía inició el Primer Plan de Calidad del Sistema Sanitario Pú blico, que ha conducido a una mejora continua de la calidad y la estandarizació n de los procedimientos basados en la evidencia clínica para el manejo efectivo de los eventos cardiovasculares y otras enfermedades.…”

Health systems organization for emergency care

“…These improvements reflect better acute care and greater access to dedicated stroke units in countries like Denmark and Sweden. Care for AMI has changed dramatically in recent decades [4,5]. Clinical practice guidelines, such as those developed by the European Society of Cardiology, provide clinicians with the best available evidence on how to optimize care.…”