Clinical profile and management of patients with incident and recurrent acute myocardial infarction in Albania - a call for more focus on prevention strategies
, , , , , and | Oct 09, 2017
About this article
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
© 2017 National Institute of Public Health, Slovenia
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.
Figure 1
Figure 2
Characteristics of the study population.
| Patient characteristics | All patients (n=324) | Incident cases (n=274) | Recurrent cases (n=50) | P value |
|---|---|---|---|---|
| Age (years), mean (SD) | 64.4 (11.4) | 63.7 (11.5) | 68.4 (10.1) | 0.01 |
| Gender (male), n (%) | 239 (73.8) | 210 (76.6) | 29 (58.0) | 0.01 |
| Education, n (%) | ||||
| Primary | 143 (44.1) | 113 (41.2) | 30 (60.0) | 0.01 |
| Secondary or higher | 181 (55.9) | 161 (58.8) | 20 (40.0) | |
| Coronary risk factors, n (%) | ||||
| Smoking | 194 (59.9) | 171 (62.4) | 23 (46.0) | 0.03 |
| Hypertension | 270 (83.3) | 229 (83.6) | 41 (82.0) | 0.78 |
| Diabetes | 164 (50.6) | 135 (49.3) | 29 (58.0) | 0.26 |
| Hypercholesterolemia | 179 (55.3) | 149 (54.4) | 30 (60.0) | 0.46 |
| At least one risk factor | 320 (98.8) | 270 (98.5) | 50 (100.0) | 0.39 |
| All four risk factors | 45 (13.9) | 39 (14.2) | 6 (12.0) | 0.63 |
| Comorbidities, n (%) | ||||
| Atrial fibrillation | 39 (12.1) | 26 (9.4) | 13 (27.7) | <0.01 |
| Peripheral artery disease | 23 (7.1) | 20 (7.2) | 3 (6.4) | 0.84 |
| Cerebrovascular disease | 25 (7.4) | 19 (6.9) | 6 (12.8) | 0.16 |
| | 17 (5.3) | 14 (5.1) | 3 (6.4) | 0.71 |
| eGFR<60 mL/min/1.73m2 | 77 (23.8) | 59 (21.5) | 18 (36.0) | 0.03 |
| Peptic ulcer | 23 (7.1) | 19 (6.9) | 4 (8.0) | 0.79 |
| Pulse (beats/min), mean (SD) | 78 (16.8) | 77 (16.5) | 80 (18.5) | 0.37 |
| Hemoglobin 4% of patients had missing values Incident cases were younger (P=0.01), more often men (P=0.01), and had attained a higher education (P=0.01) than recurrent cases. No statistically significant differences between groups were observed regarding hypertension, DM, and hypercholesterolemia. Smoking was more frequent among the incident cases (P=0.03). | 12.8 (1.9) | 12.9 (1.8) | 11.9 (1.9) | <0.01 |
Clinical profile and in-hospital treatment of patients with an acute myocardial infarction.
| All patients (n=324) | Incident cases (n=274) | Recurrent cases (n=50) | P value | |
|---|---|---|---|---|
| Clinical profile | ||||
| STEMI, n (%) | 271 (83.9) | 230 (84.3) | 41 (82.0) | 0.69 |
| Multivessel CAD, n (%) | 164 (75.9) | 136 (73.1) | 28 (93.3) | 0.03 |
| Heart failure, n (%) | 109 (33.6) | 81 (29.6) | 28 (56.0) | <0.01 |
| LVEF<0.45, n (%) | 101 (31.2) | 77 (28.1) | 24 (48.0) | 0.01 |
| AVB (2nd/3rd degree), n (%) | 13 (4.0) | 10 (3.7) | 3 (6.0) | 0.44 |
| VF, n (%) | 16 (4.9) | 11 (4.0) | 5 (10.0) | 0.07 |
| Beta-blockers | 192 (59.3) | 172 (62.8) | 20 (40.0) | 0.01 |
| ACEI/ARBs | 206 (63.6) | 179 (65.3) | 27 (54.0) | 0.12 |
| Statins | 314 (96.9) | 268 (97.8) | 46 (92.0) | 0.05 |
| Aspirin | 308 (95.1) | 261 (95.3) | 47 (94.0) | 0.71 |
| All four drug classes | 144 (44.4) | 128 (46.7) | 16 (32.0) | 0.05 |
| Invasive procedures | ||||
| Coronary angiography | 222 (68.5) | 192 (70.1) | 30 (60.0) | 0.16 |
| Revascularization Percutaneous coronary intervention or coronary artery bypass grafting among patients undergoing coronary angiography. | 139 (64.4) | 122 (65.6) | 17 (56.7) | 0.34 |