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Management of acute myocardial infarction in Auckland.
N Z Med J. 1996 Jul 12; 109(1025):248-51.NZ

Abstract

AIM

To analyse the utilisation of therapies in coronary care units for patients with acute myocardial infarction.

METHODS

An evaluation form was completed prospectively by a designated nurse in each coronary care unit of the four Auckland hospitals in 1993.

RESULTS

One thousand and eighty one patients who were admitted with definite or probable acute myocardial infarction had a coronary care unit stay of 63.4 (SD 49.3) hours, and hospital stay of 7.3 (5.1) days. The mortality for definite myocardial infarction was 13.7% (< 70 years 7.1%). Coronary angiography was performed on 10% of patients during their hospital admission, and 4.9% underwent revascularisation. Thrombolytic therapy was administered to 52% (495/948) of patients with definite infarction and 4% had contraindications. Patients aged > or = 70 years (47% vs 55% p = 0.02) or diabetics (46% vs 56%, p = 0.04) were less likely to receive thrombolysis. The utilisation of aspirin and oral beta-blockers was 86% and 40%, respectively, in patients with definite infarction and both were used less frequently in patients > or = 70 years. Intravenous beta-blockers were administered to < 1% of patients. Angiotensin converting enzyme (ACE) inhibitors were prescribed in 21%, intravenous or long acting nitrates in 41% and calcium antagonists in 14%; the latter two therapies were used more frequently in patients > or = 70 years. There was no evidence of gender or ethnic bias for either investigation or treatment.

CONCLUSION

On the basis of results of recent clinical trials, there may be under utilisation of some treatments for acute myocardial infarction including aspirin, thrombolytic therapy, beta-blockers and ACE inhibitors, while calcium antagonists may be over used.

Authors+Show Affiliations

Coronary Care Unit, Auckland Hospital.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

8692449

Citation

French, J, et al. "Management of Acute Myocardial Infarction in Auckland." The New Zealand Medical Journal, vol. 109, no. 1025, 1996, pp. 248-51.
French J, Williams B, Hart H, et al. Management of acute myocardial infarction in Auckland. N Z Med J. 1996;109(1025):248-51.
French, J., Williams, B., Hart, H., Woo, K., Wang, L., Grant, J., Ingram, C., O'Brien, P., Poole, J., Sharpe, N., Williams, M., & White, H. (1996). Management of acute myocardial infarction in Auckland. The New Zealand Medical Journal, 109(1025), 248-51.
French J, et al. Management of Acute Myocardial Infarction in Auckland. N Z Med J. 1996 Jul 12;109(1025):248-51. PubMed PMID: 8692449.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Management of acute myocardial infarction in Auckland. AU - French,J, AU - Williams,B, AU - Hart,H, AU - Woo,K, AU - Wang,L, AU - Grant,J, AU - Ingram,C, AU - O'Brien,P, AU - Poole,J, AU - Sharpe,N, AU - Williams,M, AU - White,H, PY - 1996/7/12/pubmed PY - 1996/7/12/medline PY - 1996/7/12/entrez SP - 248 EP - 51 JF - The New Zealand medical journal JO - N Z Med J VL - 109 IS - 1025 N2 - AIM: To analyse the utilisation of therapies in coronary care units for patients with acute myocardial infarction. METHODS: An evaluation form was completed prospectively by a designated nurse in each coronary care unit of the four Auckland hospitals in 1993. RESULTS: One thousand and eighty one patients who were admitted with definite or probable acute myocardial infarction had a coronary care unit stay of 63.4 (SD 49.3) hours, and hospital stay of 7.3 (5.1) days. The mortality for definite myocardial infarction was 13.7% (< 70 years 7.1%). Coronary angiography was performed on 10% of patients during their hospital admission, and 4.9% underwent revascularisation. Thrombolytic therapy was administered to 52% (495/948) of patients with definite infarction and 4% had contraindications. Patients aged > or = 70 years (47% vs 55% p = 0.02) or diabetics (46% vs 56%, p = 0.04) were less likely to receive thrombolysis. The utilisation of aspirin and oral beta-blockers was 86% and 40%, respectively, in patients with definite infarction and both were used less frequently in patients > or = 70 years. Intravenous beta-blockers were administered to < 1% of patients. Angiotensin converting enzyme (ACE) inhibitors were prescribed in 21%, intravenous or long acting nitrates in 41% and calcium antagonists in 14%; the latter two therapies were used more frequently in patients > or = 70 years. There was no evidence of gender or ethnic bias for either investigation or treatment. CONCLUSION: On the basis of results of recent clinical trials, there may be under utilisation of some treatments for acute myocardial infarction including aspirin, thrombolytic therapy, beta-blockers and ACE inhibitors, while calcium antagonists may be over used. SN - 0028-8446 UR - https://www.unboundmedicine.com/medline/citation/8692449/Management_of_acute_myocardial_infarction_in_Auckland_ DB - PRIME DP - Unbound Medicine ER -