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Preciado SM, Sharp AL, Sun BC, Baecker A, Wu YL, Lee MS, Shen E, Ferencik M, Natsui S, Kawatkar AA, Park SJ, Redberg RF. Evaluating Sex Disparities in the Emergency Department Management of Patients With Suspected Acute Coronary Syndrome. Ann Emerg Med 2021; 77:416-424. [PMID: 33358395 PMCID: PMC8005458 DOI: 10.1016/j.annemergmed.2020.10.022] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 10/02/2020] [Accepted: 10/28/2020] [Indexed: 02/06/2023]
Abstract
STUDY OBJECTIVE We compare clinical management and outcomes of emergency department (ED) encounters by sex after implementation of a clinical care pathway in 15 community EDs that standardized recommendations based on patient risk, using the History, ECG, Age, Risk Factors, and Troponin (HEART) score. METHODS This was a retrospective analysis of adult ED encounters evaluated for suspected acute coronary syndrome with a documented HEART score from May 20, 2016, to December 1, 2017. The primary outcomes were hospitalization or 30-day stress testing. Secondary outcomes included 30-day acute myocardial infarction or all-cause death (major adverse cardiac event). A generalized estimating equation regression model was used to compare the odds of hospitalization or stress testing by sex; we report HEART scores (0 to 10) stratified by sex and describing major adverse cardiac events. RESULTS A total of 34,715 adult ED encounters met the inclusion criteria (56.0% women). A higher proportion of women were classified as low risk (60.5% versus 52.4%; odds ratio [OR] 1.39; 95% confidence interval [CI] 1.33 to 1.45). Women were hospitalized or received stress testing less frequently than men for low HEART scores (18.8% versus 22.8%; OR 0.79; 95% CI 0.73 to 0.84) and intermediate ones (46.7% versus 49.7%; OR 0.88; 95% CI 0.83 to 0.95), but similarly for high-risk ones (74.1% versus 74.4%; OR 0.99; 95% CI 0.77 to 1.28). Women had 18% lower odds of hospitalization or noninvasive cardiac testing (OR 0.82; 95% CI 0.78 to 0.86), even after adjusting for HEART score and comorbidities. Men had higher risks of major adverse cardiac events than women for all HEART score categories but the risk for men was significantly higher among low-risk HEART scores (0.4% versus 0.1%). CONCLUSION Women with low-risk HEART scores are hospitalized or stress tested less than men, which is likely appropriate, and women have better outcomes than men. Use of the HEART score has the potential to reduce sex disparities in acute coronary syndrome care.
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Affiliation(s)
- Salena M Preciado
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA
| | - Adam L Sharp
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA
| | - Benjamin C Sun
- Department of Emergency Medicine, University of Pennsylvania, Leonard Davis Institute, Philadelphia, PA
| | - Aileen Baecker
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA
| | - Yi-Lin Wu
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA
| | - Ming-Sum Lee
- Division of Cardiology, Kaiser Permanente Southern California, Los Angeles Medical Center, Los Angeles, CA
| | - Ernest Shen
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA
| | - Maros Ferencik
- Knight Cardiovascular Institute, Oregon Health & Science University, Portland, OR
| | - Shaw Natsui
- New York City Health + Hospitals, New York, NY
| | - Aniket A Kawatkar
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA
| | - Stacy J Park
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA
| | - Rita F Redberg
- Division of Cardiology, University of California-San Francisco, San Francisco, CA.
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Alyasin N, Teate A, Strickland K. The experience of women following first acute coronary syndrome: An integrative literature review. J Adv Nurs 2021; 77:2228-2247. [PMID: 33393122 DOI: 10.1111/jan.14677] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 10/28/2020] [Accepted: 11/06/2020] [Indexed: 11/30/2022]
Abstract
AIM There is lack of evidence and research understanding among women's lived experiences following first acute coronary syndrome, thus their recovery process remains poorly understood. To date research has largely focused on men's experience of acute coronary syndrome while this area of health care and recovery has considerable impact on women's health and quality of life. Our aim was to review the literature exploring lived experience of women following first acute coronary syndrome. DESIGN Integrative review of the literature. DATA SOURCE We searched PubMed, MEDLINE, EMBASE, CINAHL and Scopus from 2008-2018 for articles published in English. REVIEW METHOD Of 1675 publications identified, 18 qualitative, quantitative, and mixed method studies met our inclusion criteria. Quality of included studies was assessed using Joanna Briggs Institute quality assessment tools. Findings were integrated using thematic synthesis. RESULTS Experiencing acute coronary syndrome was reported to have significant impacts on women's lives. The most common issues reported were physical limitations, fear, and uncertainties about the future, sexual dissatisfaction, and social isolation. Women also reported to have higher short- and long-term mortality rate, stroke, recurrent, and hospital readmissions compared with men. CONCLUSION This review identified current knowledge and gaps about lived experience of women following first acute coronary syndrome. It is anticipated that the information gained from this literature review will support new research aimed at improving the care women receive following acute coronary syndrome and therefore enhance their recovery and quality of life. IMPACT This review contributes to the current body of knowledge by addressing women's physical, psychosocial, and sexual state following acute coronary syndrome. Improvement in women's quality of life after acute coronary syndrome necessitates further research which ultimately results in better management and treatment of women and their recovery following first acute coronary syndrome.
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Affiliation(s)
- Najmeh Alyasin
- School of Nursing, Midwifery and Public Health, Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
| | - Alison Teate
- School of Nursing, Midwifery and Public Health, Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
| | - Karen Strickland
- School of Nursing, Midwifery and Public Health, Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
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Oliveira ACMD, Ferreira RC, Santos AA. Cardiovascular risk assessment according to the Framingham score and abdominal obesity in individuals seen by a clinical school of nutrition. Rev Assoc Med Bras (1992) 2017; 62:138-44. [PMID: 27167543 DOI: 10.1590/1806-9282.62.02.138] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2014] [Accepted: 10/21/2014] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVE To analyze the relation of abdominal obesity on cardiovascular risk in individuals seen by a clinic school of nutrition, classifying them based on Framingham score. METHODS Cross-sectional study, conducted at the nutrition clinic of a private college in the city of Maceió, Alagoas. We included randomly selected adults and elderly individuals with abdominal obesity, of both sexes, treated from August to December of 2009, with no history of cardiomyopathy or cardiovascular events. To determine the cardiovascular risk, the Framingham score was calculated. All analyzes were performed with SPSS software version 20.0, with p <0.05 as significative. RESULTS We studied 54 subjects, 83% female, the mean age was 48 years old, ranging from 31 to 73 years. No correlation was observed between measurements of waist circumference and cardiovascular risk in the subjects studied (r=0.065, p=0.048), and there was no relationship between these parameters. CONCLUSION Abdominal fat distribution was weakly related to cardiovascular risk in patients seen by a clinical school of nutrition.
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O'Neil A, Fisher AJ, Kibbey KJ, Jacka FN, Kotowicz MA, Williams LJ, Stuart AL, Berk M, Lewandowski PA, Atherton JJ, Taylor CB, Pasco JA. The addition of depression to the Framingham Risk Equation model for predicting coronary heart disease risk in women. Prev Med 2016; 87:115-120. [PMID: 26906397 DOI: 10.1016/j.ypmed.2016.02.028] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Revised: 02/02/2016] [Accepted: 02/18/2016] [Indexed: 10/22/2022]
Abstract
BACKGROUND Depression is widely considered to be an independent and robust predictor of Coronary Heart Disease (CHD), however is seldom considered in the context of formal risk assessment. We assessed whether the addition of depression to the Framingham Risk Equation (FRE) improved accuracy for predicting 10-year CHD in a sample of women. DESIGN A prospective, longitudinal design comprising an age-stratified, population-based sample of Australian women collected between 1993 and 2011 (n=862). METHODS Clinical depressive disorder was assessed using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders (SCID-I/NP), using retrospective age-of-onset data. A composite measure of CHD included non-fatal myocardial infarction, unstable angina coronary intervention or cardiac death. Cox proportional-hazards regression models were conducted and overall accuracy assessed using area under receiver operating characteristic (ROC) curve analysis. RESULTS ROC curve analyses revealed that the addition of baseline depression status to the FRE model improved its overall accuracy (AUC:0.77, Specificity:0.70, Sensitivity:0.75) when compared to the original FRE model (AUC:0.75, Specificity:0.73, Sensitivity:0.67). However, when calibrated against the original model, the predicted number of events generated by the augmented version marginally over-estimated the true number observed. CONCLUSIONS The addition of a depression variable to the FRE equation improves the overall accuracy of the model for predicting 10-year CHD events in women, however may over-estimate the number of events that actually occur. This model now requires validation in larger samples as it could form a new CHD risk equation for women.
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Affiliation(s)
- Adrienne O'Neil
- Melbourne School of Population & Global Health, University of Melbourne, Carlton, VIC, Australia; School of Medicine, Deakin University, Geelong, VIC, Australia; School of Public Health and Preventive Medicine, Monash University, Prahran, VIC, Australia.
| | - Aaron J Fisher
- Department of Psychology, University of California Berkeley, CA, USA
| | - Katherine J Kibbey
- Barwon Health, Geelong Hospital, Geelong, VIC, Australia; Monash Health, Melbourne, VIC, Australia; School of Clinical Sciences, Monash University VIC, Australia
| | - Felice N Jacka
- School of Medicine, Deakin University, Geelong, VIC, Australia; Department of Psychiatry, The University of Melbourne, Parkville, VIC, Australia; Centre for Adolescent Health, Murdoch Children's Research Centre, Parkville, VIC, Australia; Black Dog Institute, Hospital Road, Prince of Wales Hospital, Randwick, NSW, Australia
| | - Mark A Kotowicz
- School of Medicine, Deakin University, Geelong, VIC, Australia; Barwon Health, Geelong Hospital, Geelong, VIC, Australia; Black Dog Institute, Hospital Road, Prince of Wales Hospital, Randwick, NSW, Australia
| | - Lana J Williams
- School of Medicine, Deakin University, Geelong, VIC, Australia
| | - Amanda L Stuart
- School of Medicine, Deakin University, Geelong, VIC, Australia
| | - Michael Berk
- School of Medicine, Deakin University, Geelong, VIC, Australia; School of Public Health and Preventive Medicine, Monash University, Prahran, VIC, Australia; Department of Psychiatry, The University of Melbourne, Parkville, VIC, Australia; Orygen Youth Health Research Centre, Parkville, VIC, Australia; Mental Health Research Institute, Parkville, VIC, Australia
| | | | - John J Atherton
- Department of Cardiology, Royal Brisbane and Women's Hospital, QLD, Australia; School of Medicine, University of Queensland, QLD, Australia
| | - Craig B Taylor
- Department of Psychiatry & Behavioral Medicine, Stanford University & Palo Alto University, CA, USA
| | - Julie A Pasco
- School of Medicine, Deakin University, Geelong, VIC, Australia; Western Medical School, The University of Melbourne, St Albans, VIC, Australia
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O'Neil A, Fisher AJ, Kibbey KJ, Jacka FN, Kotowicz MA, Williams LJ, Stuart AL, Berk M, Lewandowski PA, Taylor CB, Pasco JA. Depression is a risk factor for incident coronary heart disease in women: An 18-year longitudinal study. J Affect Disord 2016; 196:117-24. [PMID: 26921864 DOI: 10.1016/j.jad.2016.02.029] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Revised: 11/12/2015] [Accepted: 02/06/2016] [Indexed: 10/22/2022]
Abstract
BACKGROUND According to a recent position paper by the American Heart Association, it remains unclear whether depression is a risk factor for incident Coronary Heart Disease (CHD). We assessed whether a depressive disorder independently predicts 18-year incident CHD in women. METHOD A prospective longitudinal study of 860 women enrolled in the Geelong Osteoporosis Study (1993-2011) was conducted. Participants were derived from an age-stratified, representative sample of women (20-94 years) randomly selected from electoral rolls in South-Eastern Australia. The exposure was a diagnosis of a depressive disorder using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders. Outcomes data were collected from hospital medical records: (1) PRIMARY OUTCOME: a composite measure of cardiac death, non-fatal Myocardial Infarction or coronary intervention. (2) Secondary outcome: any cardiac event (un/stable angina, cardiac event not otherwise defined) occurring over the study period. RESULTS Seven participants were excluded based on CHD history. Eighty-three participants (9.6%) recorded ≥1 cardiac event over the study period; 47 had a diagnosis that met criteria for inclusion in the primary analysis. Baseline depression predicted 18-year incidence, adjusting for (1) anxiety (adj. OR:2.39; 95% CIs:1.19-4.82), plus (2) typical risk factors (adj. OR:3.22; 95% CIs:1.45-6.93), plus (3) atypical risk factors (adj. OR:3.28; 95% CIs:1.36-7.90). This relationship held when including all cardiac events. No relationship was observed between depression and recurrent cardiac events. CONCLUSION The results of this study support the contention that depression is an independent risk factor for CHD incidence in women. Moreover, the strength of association between depression and CHD incidence was of a greater magnitude than any typical and atypical risk factor.
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Affiliation(s)
- Adrienne O'Neil
- Melbourne School of Population & Global Health, University of Melbourne, Carlton, VIC, Australia; School of Medicine, Deakin University, Geelong, VIC, Australia; School of Public Health and Preventive Medicine, Monash University, Prahran, VIC, Australia.
| | - Aaron J Fisher
- Department of Psychology, University of California, Berkeley, CA, USA
| | - Katherine J Kibbey
- Barwon Health, Geelong Hospital, Geelong, VIC, Australia; Monash Health, Melbourne, VIC, Australia; School of Clinical Sciences, Monash University, Melbourne, Australia
| | - Felice N Jacka
- School of Medicine, Deakin University, Geelong, VIC, Australia; Department of Psychiatry, The University of Melbourne, Parkville, VIC, Australia; Centre for Adolescent Health, Murdoch Children's Research Centre, Parkville, VIC, Australia; Black Dog Institute, Hospital Road, Prince of Wales Hospital, Randwick, NSW, Australia
| | - Mark A Kotowicz
- School of Medicine, Deakin University, Geelong, VIC, Australia; Barwon Health, Geelong Hospital, Geelong, VIC, Australia; Department of Psychiatry & Behavioral Medicine, Stanford University & Palo Alto University, CA, USA
| | - Lana J Williams
- School of Medicine, Deakin University, Geelong, VIC, Australia
| | - Amanda L Stuart
- School of Medicine, Deakin University, Geelong, VIC, Australia
| | - Michael Berk
- School of Medicine, Deakin University, Geelong, VIC, Australia; School of Public Health and Preventive Medicine, Monash University, Prahran, VIC, Australia; Department of Psychiatry, The University of Melbourne, Parkville, VIC, Australia; Orygen Youth Health Research Centre, Parkville, VIC, Australia; Mental Health Research Institute, Parkville, VIC, Australia
| | | | - Craig B Taylor
- Department of Psychiatry & Behavioral Medicine, Stanford University & Palo Alto University, CA, USA
| | - Julie A Pasco
- School of Medicine, Deakin University, Geelong, VIC, Australia; Western Medical School, The University of Melbourne, St Albans, VIC, Australia
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Sibbritt D, Davidson P, DiGiacomo M, Newton P, Adams J. Use of Complementary and Alternative Medicine in Women With Heart Disease, Hypertension and Diabetes (from the Australian Longitudinal Study on Women's Health). Am J Cardiol 2015; 115:1691-5. [PMID: 25896149 DOI: 10.1016/j.amjcard.2015.03.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2014] [Revised: 03/13/2015] [Accepted: 03/13/2015] [Indexed: 10/23/2022]
Abstract
The uptake of complementary and alternative medicine (CAM) is common, especially among patients with chronic illness. However, the use of CAM by women with cardiovascular disease and how this influences the interface with conventional medicine is poorly understood. To examine the relation between heart disease, hypertension, and diabetes and the use of CAM and conventional medicine in a cohort of women, data were taken from the 2010 survey (n = 9,748) of the 1946 to 1951 cohort of the Australian Longitudinal Study on Women's Health (ALSWH). Analyses focused on women who had been diagnosed or treated for heart disease, diabetes, and/or hypertension. The outcome measures were the use of conventional or CAM treatments in the previous year. Most women had hypertension only (n = 2,335), and few (n = 78) reported having heart disease, hypertension, and diabetes. Women with hypertension were less likely (odds ratio [OR] 0.82, 95% confidence interval [CI] 0.74 to 0.91) to consult with a CAM practitioner and less likely (OR 0.86, 95% CI 0.77 to 0.97) to use self-prescribed CAM, while women with diabetes were also less likely (OR 0.66, 95% CI 0.54 to 0.81) to consult with a CAM practitioner and less likely (OR 0.68, 95% CI 0.55 to 0.83) to use self-prescribed CAM. In conclusion, compared with studies conducted on CAM use and other chronic illness groups, the use of CAM by women with heart disease, hypertension, and/or diabetes in this study was lower, and future research is needed to explore patients' perceptions of cardiovascular risk and the role of CAM in their self-management in the community, among other issues.
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Abstract
AIMS Elderly women with myocardial infarction (MI) show poorer outcomes than men. In patients with MI, reduced heart rate variability (HRV) is associated with an increased risk of mortality. Thus, we aimed to investigate HRV in elderly women with MI. METHODS HRV indexes in women 50 years of age or older were compared to those in age-adjusted men with MI: geometric (triangular index), linear (low frequency [LF, ms(2)], high frequency [HF, ms(2)], standard deviation (SD) of normal R-R wave intervals [SDNN], square root of the mean of the sum of the squares of differences between adjacent normal R wave intervals [RMSSD]) and nonlinear Poincaré analysis [SD1 and SD2, ms]. RESULTS Women had higher MI recurrence than men (11% vs. 5% with two MIs; 6% vs. 1% with three MIs). Overall HRV, the triangular index and SDNN were considerably lower in women than men (3.1 [2.5-4.4] vs. 4.5 [3.2-5.9] and 9.3 [6.9-15.8] vs. 19.2 [11.4-26.4] respectively; p < 0.001). Moreover, HRV indexes (HF, LF/HF, RMSSD, and SD1) were significantly lower in women (62.2%, 55.6%, 37.1%, and 37.2% respectively; p < 0.01). CONCLUSION This study suggests that elderly women with MI may have a worse prognosis than men, indicated by cardiac autonomic dysfunction. Since our study is cross-sectional and cannot infer causality, causation should be confirmed in further longitudinal studies.
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Affiliation(s)
- Andreia de Oliveira Pinheiro
- a Center of Innovation, Technology and Education - (CITE), Camilo Castelo Branco University , Sao Jose dos Campos , Brazil
| | - Valter Luis Pereira
- a Center of Innovation, Technology and Education - (CITE), Camilo Castelo Branco University , Sao Jose dos Campos , Brazil
| | - Ovidiu Constantin Baltatu
- a Center of Innovation, Technology and Education - (CITE), Camilo Castelo Branco University , Sao Jose dos Campos , Brazil
| | - Luciana Aparecida Campos
- a Center of Innovation, Technology and Education - (CITE), Camilo Castelo Branco University , Sao Jose dos Campos , Brazil
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Park SJ, Choi NK, Park KH, Woo SJ. Nationwide incidence of clinically diagnosed retinal vein occlusion in Korea, 2008 through 2011: preponderance of women and the impact of aging. Ophthalmology 2014; 121:1274-80. [PMID: 24491641 DOI: 10.1016/j.ophtha.2013.12.024] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2013] [Revised: 12/10/2013] [Accepted: 12/12/2013] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE This study aimed at defining the incidence and demographics of clinically diagnosed retinal vein occlusion (RVO) in Korea. DESIGN Nationwide population-based retrospective study using data entered into the Korean national health claims database from 2007 through 2011. PARTICIPANTS Data of the entire population of Korea (n = 47,990,761, based on the 2010 census) were analyzed. METHODS The Korean national health claims database was analyzed to identify patients with RVO. Incident cases included individuals with no RVO claims in 2007, but with RVO claims in the years 2008 through 2011. The incidence rate of RVO was estimated for the entire Korean population. MAIN OUTCOME MEASURES The person-time incidence rates of clinically diagnosed RVO in Korea, including the age- and gender-specific incidence rates, were estimated. RESULTS A total of 92 730 RVO cases (56.4% in women) were identified. The incidence rate of clinically diagnosed RVO during the study period was 48.31 per 100,000 person-years (95% confidence interval [CI], 48.00-48.62). The incidence rate among men and women was 42.40 (95% CI, 41.99-42.81) and 54.14 (95% CI, 53.67-54.60) per 100,000 person-years, respectively (P < 0.001). The highest incidence of 214.92 per 100,000 person-years (95% CI, 211.29-218.56) was observed in the age group of 70 to 74 years (186.62 [95% CI, 181.46-191.78] and 236.25 [95% CI, 231.21-241.29] per 100,000 person-years for men and women aged 70 to 74 years, respectively). The incidence rate of RVO increased as the age of the population increased-more than doubling approximately every 10 years from the second to the seventh decade of life. Retinal vein occlusion occurred more often in men 30 to 54 years of age and in men older than 85 years, but was more common in women 55 to 84 years of age. CONCLUSIONS This study reports the population-based RVO incidence in Korea. The RVO incidence increased exponentially as the age of the population increased, and the RVO incidence in women was 1.28 times higher than that in men.
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Affiliation(s)
- Sang Jun Park
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Nam-Kyong Choi
- Medical Research Collaborating Center, Seoul National University Hospital and Seoul National University College of Medicine, Seoul, South Korea; Institute of Environmental Medicine, Seoul National University Medical Research Center, Seoul, South Korea
| | - Kyu Hyung Park
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Se Joon Woo
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea.
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Ghaffari S, Hakim H, Pourafkari L, Asl ES, Goldust M. Twenty-year route of prevalence of risk factors, treatment patterns, complications, and mortality rate of acute myocardial infarction in Iran. Ther Adv Cardiovasc Dis 2013; 7:117-22. [PMID: 23637278 DOI: 10.1177/1753944712474093] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES Coronary artery diseases are regarded as the main cause of mortality in most countries. The present study aims at evaluating variations and studying its complications in Iranian patients within past 20 years. METHODS This cross-sectional analytical-descriptive study retrospectively evaluated the files of 600 patients with acute myocardial infarction during a 20-year period. Basic data and laboratory information, chemotherapies and intervention treatments of patients were registered in special forms and compared regarding the mentioned time intervals. RESULTS There were 440 (73.3%) male and 160 (26.7%) female patients and mean age of the patients was 60.03 ± 11.61 years. Mean duration of hospitalization (p < 0.001) and prevalence of smoking (p < 0.001) had significantly decreased in the past two decades. There was no meaningful difference when considering mortality rate (p = 0.533) and cardiac insufficiency (p = 0.403). CONCLUSION The results indicate prominent improvement in the management process of patients suffering from acute myocardial infarction within the past 20 years.
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Affiliation(s)
- Samad Ghaffari
- Department of Cardiology, Tabriz University of Medical Sciences, Tabriz, Iran
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