<abstract xmlns="http://www.w3.org/1999/xhtml"><sec id="j_sjph-2017-0032_s_009_w2aab3b7b7b1b6b1aab1c18b1Aa"><h3>Background</h3><p>The clinical profile of acute myocardial infarction (AMI) patients reflects the burden of risk factors in the general population. Differences between incident (first) and recurrent (repeated) events and their impact on treatment are poorly described. We studied potential differences in the clinical profile and in-hospital treatment between patients hospitalised with an incident and recurrent AMI.</p></sec><sec id="j_sjph-2017-0032_s_010_w2aab3b7b7b1b6b1aab1c18b2Aa"><h3>Methods</h3><p>A total of 324 patients admitted in the Coronary Care Unit of  ‘Mother Teresa’ hospital, Tirana, Albania (2013-2014), were included in the study. Information on AMI type, complications and risk factors was obtained from patient’s medical file.</p><p>Logistic regression analyses were used to explore differences between the incident and recurrent AMIs regarding clinical profile and in-hospital treatment.</p></sec><sec id="j_sjph-2017-0032_s_011_w2aab3b7b7b1b6b1aab1c18b3Aa"><h3>Results</h3><p>Of all patients, 50 (15.4%) had a prior AMI. Compared to incident cases, recurrent cases were older (P=0.01), more often women (P=0.01), less educated (P=0.01), and smoked less (P=0.03). Recurrent cases experienced more often heart failure (HF) (OR=2.48; 95% CI: 1.31–4.70), impaired left ventricular ejection fraction (OR=1.97; 95% CI:1.05–3.71), and multivessel disease (OR=6.32; 95% CI: 1.43–28.03) than incident cases. In-hospital use of beta-blockers was less frequent among recurrent compared to incident cases (OR=0.45; 95% CI: 0.24–0.85), while no statistically significant differences between groups were observed regarding angiotensin-converting enzyme inhibitor/angiotensin receptor blocker, statin, aspirin or invasive procedures.</p></sec><sec id="j_sjph-2017-0032_s_012_w2aab3b7b7b1b6b1aab1c18b4Aa"><h3>Conclusion</h3><p>A more severe clinical expression of the disease and underutilisation of treatment among recurrent AMIs are likely to explain their poorer prognosis compared to incident AMIs.</p></sec></abstract>

BackgroundThe clinical profile of acute myocardial infarction (AMI) patients reflects the burden of risk factors in the general population. Differences between incident (first) and recurrent (repeated) events and their impact on treatment are poorly described. We studied potential differences in the clinical profile and in-hospital treatment between patients hospitalised with an incident and recurrent AMI.MethodsA total of 324 patients admitted in the Coronary Care Unit of  ‘Mother Teresa’ hospital, Tirana, Albania (2013-2014), were included in the study. Information on AMI type, complications and risk factors was obtained from patient’s medical file.Logistic regression analyses were used to explore differences between the incident and recurrent AMIs regarding clinical profile and in-hospital treatment.ResultsOf all patients, 50 (15.4%) had a prior AMI. Compared to incident cases, recurrent cases were older (P=0.01), more often women (P=0.01), less educated (P=0.01), and smoked less (P=0.03). Recurrent cases experienced more often heart failure (HF) (OR=2.48; 95% CI: 1.31–4.70), impaired left ventricular ejection fraction (OR=1.97; 95% CI:1.05–3.71), and multivessel disease (OR=6.32; 95% CI: 1.43–28.03) than incident cases. In-hospital use of beta-blockers was less frequent among recurrent compared to incident cases (OR=0.45; 95% CI: 0.24–0.85), while no statistically significant differences between groups were observed regarding angiotensin-converting enzyme inhibitor/angiotensin receptor blocker, statin, aspirin or invasive procedures.ConclusionA more severe clinical expression of the disease and underutilisation of treatment among recurrent AMIs are likely to explain their poorer prognosis compared to incident AMIs.

Clinical profile and management of patients with incident and recurrent acute myocardial infarction in Albania - a call for more focus on prevention strategies

University of Bergen, Faculty of Medicine and Dentistry

Department of Global Public Health and Primary Care

Maastricht University, Faculty of Health, Medicine and Life Sciences, School for Public Health and Primary Care

Department of Public Health and Community Medicine

University of Medicine, Faculty of Medicine

Slovenian Journal of Public Health

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

KLINIČNI PROFIL IN ZDRAVLJENJE PACIENTOV S PRVIM IN PONOVNIM POJAVOM AKUTNEGA MIOKARDNEGA INFARKTA V ALBANIJI - POZIV ZA VEČJO POZORNOST NA PODROČJU PREVENTIVNIH STRATEGIJ

BackgroundThe clinical profile of acute myocardial infarction (AMI) patients reflects the burden of risk factors in the general population. Differences between...

Clinical profile and management of patients with incident and recurrent acute myocardial infarction in Albania - a call for more focus on prevention strategies

Article Category: Original scientific article

Published Online: Oct 09, 2017

Page range: 236 - 243

Received: Nov 29, 2016

Accepted: Aug 07, 2017

DOI: https://doi.org/10.1515/sjph-2017-0032

Keywords
acute myocardial infarction, epidemiology, in-hospital treatment, prevention, Albania

© 2017 National Institute of Public Health, Slovenia

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Clinical profile and management of patients with incident and recurrent acute myocardial infarction in Albania - a call for more focus on prevention strategies

Article Category: Original scientific article

Published Online: Oct 09, 2017

Page range: 236 - 243

Received: Nov 29, 2016

Accepted: Aug 07, 2017

DOI: https://doi.org/10.1515/sjph-2017-0032

Keywordsacute myocardial infarction, epidemiology, in-hospital treatment, prevention, Albania

© 2017 National Institute of Public Health, Slovenia

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Keywords
acute myocardial infarction, epidemiology, in-hospital treatment, prevention, Albania