Myocardial Infarction In Chile Research Articles

Facilitators and barriers to the adoption of healthy lifestyles after first myocardial infarction in Chile: A qualitative study

Los factores asociados con el cambio terapeutico de estilos de vida (TLC) despues de un infarto agudo al miocardio (IAM) no han sido suficientemente investigados en Chile. El objetivo de este estudio fue explorar y describir los facilitadores y barreras para la adopcion de TLC en pacientes que han sufrido un primer IAM. Metodos: Estudio cualitativo basado en entrevistas en profundidad y grupos focales con cardiologos y pacientes que tuvieron un primer IAM un ano ± 2 meses antes del inicio del estudio. Se uso metodologia de Teoria Fundada para guiar el muestreo y la codificacion de los datos. Resultados: Veintiun pacientes con un primer IAM y 14 cardiologos participaron en las entrevistas en profundidad y grupos focales, hasta el punto de saturacion teorica. Facilitadores para TLC incluyeron optimismo, autoeficacia, proposito de vida basado en la fe, actitudes positivas por familiares y amigos, participacion social, buena relacion medico-paciente, y un consejo medico positivo. Las barreras fueron: individuales (edad avanzada, sexo femenino, bajo nivel educacional, creencias limitantes entre los pacientes, ambivalencia, estado de animo depresivo, falta de conocimiento sobre estrategias para lograr TLC, limitaciones financieras), a nivel familiar (crisis de la familia, sobreproteccion, imposicion de actitudes, habitos no saludables en el hogar), a nivel laboral (sobrecarga de trabajo y competencia entre la recuperacion del trabajo y la adopcion de TLC), a nivel socio-ambiental (inseguridad del barrio), y a nivel del proveedor de salud (mala relacion medico-paciente, creencias limitantes entre los medicos, consejo medico impreciso o basado en restricciones, formacion medica centrada en aspectos farmacologicos e intervencionales por sobre lo preventivo, y problemas de organizacion). Conclusiones: Los facilitadores y barreras reportados mejoran la comprension del proceso de cambio de estilos de vida despues del primer infarto agudo al miocardio, y pueden contribuir a la optimizacion de estrategias de prevencion cardiovascular secundaria en pacientes chilenos.

Younger Women Have a Higher Risk of In-Hospital Mortality Due to Acute Myocardial Infarction in Chile

Introduction and objectivesCoronary heart disease is the second cause of death in Chilean women, with higher mortality among women, especially at younger ages. The objective was to analyze in-hospital case-fatality by sex and age in patients with acute myocardial infarction in Chile and to evaluate associated factors. MethodsFrom the nationwide hospital admissions database and the GEMI registry (a multicenter registry), we selected all cases of acute myocardial infarction (code: I.21) that occurred between 2001 and 2007 in Chile. We estimated odds ratios for in-hospital case-fatality in women by age (crude and adjusted for clinical characteristics and treatment). ResultsIn total, 49 287 cases of acute myocardial infarction were hospitalized, 31.3% of them women; 9278 patients were incorporated in the GEMI registry (27.1% women). In-hospital case-fatality was higher (P<.001) in women than men (national database, 20.4% vs 11.3%; GEMI, 14.2% vs 7.3%, irrespective of age. In-hospital case-fatality risk was higher in women aged<45 years: national odds ratio=2.3 (95% confidence interval, 1.5-3.3) and GEMI, odds ratio=2.7 (1.1-6.8). The estimated risk was lower in women aged 75 or more years in both databases, 1.3 (1.2-2.4) and 1.5 (1.2-1.9), respectively. Younger women less often received statins, odds ratio=0.7 (0.6-0.8); acetylsalicylic acid, odds ratio=0.4 (0.2-0.6); betablockers, odds ratio=0.8 (0.6-0.9), and thrombolytics, odds ratio=0.6 (0.5-0.8). An interaction was found between Killip class and sex. After adjusting for covariates, women aged<55 years with ST-segment elevation myocardial infarction and Killip class I-II, had the highest risk, odds ratio=4.3 (2.1-8.9). ConclusionsIn the context of a Latin American country, women aged<55 years with ST-segment elevation myocardial infarction and Killip class I-II had a higher risk of death. Known risk factors do not completely explain this excess of risk.

Las mujeres jóvenes en Chile tienen elevado riesgo de muerte intrahospitalaria por infarto de miocardio

Introduction and objectivesCoronary heart disease is the second cause of death in Chilean women, with higher mortality among women, especially at younger ages. The objective was to analyze in-hospital case-fatality by sex and age in patients with acute myocardial infarction in Chile and to evaluate associated factors. MethodsFrom the nationwide hospital admissions database and the GEMI registry (a multicenter registry), we selected all cases of acute myocardial infarction (code: I.21) that occurred between 2001 and 2007 in Chile. We estimated odds ratios for in-hospital case-fatality in women by age (crude and adjusted for clinical characteristics and treatment). ResultsIn total, 49 287 cases of acute myocardial infarction were hospitalized, 31.3% of them women; 9278 patients were incorporated in the GEMI registry (27.1% women). In-hospital case-fatality was higher (P<.001) in women than men (national database, 20.4% vs 11.3%; GEMI, 14.2% vs 7.3%, irrespective of age. In-hospital case-fatality risk was higher in women aged<45 years: national odds ratio=2.3 (95% confidence interval, 1.5-3.3) and GEMI, odds ratio=2.7 (1.1-6.8). The estimated risk was lower in women aged 75 or more years in both databases, 1.3 (1.2-2.4) and 1.5 (1.2-1.9), respectively. Younger women less often received statins, odds ratio=0.7 (0.6-0.8); acetylsalicylic acid, odds ratio=0.4 (0.2-0.6); betablockers, odds ratio=0.8 (0.6-0.9), and thrombolytics, odds ratio=0.6 (0.5-0.8). An interaction was found between Killip class and sex. After adjusting for covariates, women aged<55 years with ST-segment elevation myocardial infarction and Killip class I-II, had the highest risk, odds ratio=4.3 (2.1-8.9). ConclusionsIn the context of a Latin American country, women aged<55 years with ST-segment elevation myocardial infarction and Killip class I-II had a higher risk of death. Known risk factors do not completely explain this excess of risk.Full English text available from:www.revespcardiol.org/en.

Incidence and case fatality due to acute myocardial infarction in Chile in the period 2001-2007

Acute myocardial infarction (AMI) causes 73.6% of coronary heart disease (CHD) deaths in Chile. To estimate the incidence and case fatality of AMI and analyze their trends between 2001-2007. A time-series study analyzing all cases of AMI (according to the International Classification of Diseases (ICD)-10, I21 code), registered in the National Hospitalizations and Death databases. Annual incidence rates and case fatality by sex and age groups were calculated. The direct method was used to standardize rates by age, using the World Health Organization 2000 Population. Prais-Winsten regression models were used to evaluate trends, expressed as relative change. Between 2001 and 2007, we estimated that 83,754 cases of AMI occurred. Standardized annual incidence rate was 74.4 per 100,000 inhabitants (98.0 in men and 51.0 in women). Incidence rates increased by 34% in individuals < 45 years of age and 9.2% in the group 55-64 years (p < 0.001, both). Total case fatality was 49.5% (45.4% in men and 57.2% in women; p < 0.001), and its trend analysis showed a significant annual reduction of 1.2% in men and 0.81% in women. In-hospital case fatality was 14.2% (11.3 and 20.4% in men and women, respectively; p < 0.001). There was a significant annual reduction of mortality (0.57 and 1.01% in men and women, respectively (p < 0.05). The incidence of AMI was stable in the whole population, but increased in younger age groups. Total and in-hospital case-fatality decreased. Despite the greater reduction of case fatality in women, they still have a higher risk of dying while in hospital.

P2-217 Trends in incidence and case-fatality of acute myocardial infarction in Chile, 2001–2007

IntroductionIn Chile, coronary heart disease is the main cause of death in men and the second in women. Acute Myocardial Infarction (AMI) causes 73.6% of coronary heart disease deaths registered...

P2-218 Secondary prevention in acute myocardial infarction in Chile

BackgroundIn 2005 the Chilean government started a healthcare reform that guarantees medical treatment for patients with acute myocardial infarction (MI), including secondary prevention.AimTo evaluate the impact of this program in...

Mortalidad por infarto agudo al miocardio en Chile: 1990-2001

Acute myocardial infarction is the first cause of death among adults in Chile. It caused 5,650 deaths during 2001. To analyze the evolution and mortality of Acute Myocardial Infarction in Chile between 1990 and 2001. Analysts of data on mortality caused by Acute Myocardial Infarction in Chile, obtained from the databases of the Ministry of Health. The adjusted morality rates and disability adjusted life years (DALY) were calculated for the period. In the study period, adjusted mortarlity decreased from 86 to 67.6 deaths/100,000 inhabitants. The DALYs ratio between men and women increased from 2.7 to 2.9. The mean death age for men and women was 69.9 and 76.5 years respectively (p <0.001). Forty five percent of women and 51% of men died at home, 78% of women and 66% of men received medical attention. Although there was a reduction in mortality caused by acute myocardial infarction in the study period, there are still gender differences in the age of death, and access to medical care.

Patterns of prescription in myocardial infarction in Chile

Patterns of prescription in myocardial infarction in Chile