Evolution in the Management of Acute Myocardial Infarction in the Autonomous Community of Valencia (Spain): Ten Years of the Primvac Registry (1995-2004)

摘要

Introduction and objectives: Several registries of acute myocardial infarction (AMI) have been carried out inSpain, but few remain active. This work analyses the evolution of the characteristics and control of patients withAMI during the first 10 years of the PRIMVAC registry, initiated in 1995. Methods: The demographical andclinical characteristics, therapeutic-diagnostic procedures and pharmacological treatment of patients admittedwith AMI between January 1995 and December 2004, were analysed in 17 coronary centres in the AutonomousCommunity of Valencia (South eastern Spain). Results: The mean age of the 19,719 patients recruited was of 65.The percentage of women, hypertension, hypercholestrolemia and diabetes increased during registry period.The median time of symptoms onset-hospital arrival was 151 minutes, without a decrease over the time, andthe delay of thrombolysis fell from 200 to 154 minutes (p<0.01). Percentage of thrombolytic treatment oscillatedbetween 39% and 48%. The mortality in the coronary units decreased (14.1% vs. 8.9%; p<0.001). The numberof coronary angiography and percutaneous revascularisation performed increased up to 61% and 32%, respec-tively, of patients included. On discharge, the use of beta-blockers (29.3% vs. 66.7%), angiotensin-convertingenzyme (ACE) inhibitors (41.7% vs. 57.9%) and statins (29.3% vs. 71%) went up. Conclusions: Overall mor-tality in the coronary unit decreased, without any variation in the incidence of serious complications. Time tothrombolysis was reduced over the time, with no significant increment in its use. The performance of coronaryangiography and percutaneous revascularisation increased, with a low use of primary angioplasty. The use ofbeta-blockers, ACE inhibitors and statins increased at discharge.