Temporal tendency of in-hospital lethality due to acute myocardial infarction. 1994-2003
Mattos, M.Antonio.de.; Toledo, D.Gusmão.; Mattos, C.Eduardo.de.; Tura, B.Rangel.; Gadelha, D.Neri.Benevides.; Siqueira Filho, A.Gonçalves.de.
Arquivos brasileiros de cardiologia 84(5): 416-421
2005
ISSN/ISBN: 0066-782X PMID: 15917976 Document Number: 587697
To analyze the temporal tendency of lethality due to acute myocardial infarction (AMI) and if the change in behavior directly interfered in such lethality. 1055 non-selected patients, who were hospitalized in coronary unit from 1994 to 2003, were assessed. Clinical and therapeutic profile-related variables were analyzed. The statistic analysis used the exponential damping of temporal series and other techniques, such as the logistic linear regression. The average lethality was 10.8%, being 12% in 1994 and 7% in 2002 (p=0.000), a relative reduction of 58%. There was no significant variation in the risk profile of the patients. There were 67.4% of men and 32.4% of women, with an average age of 60.93 and 64.84 years old, respectively. It was observed a significant increase in the percentage of cardiac catheterization (from 14% to 51%), in the angioplasty carried out 24 hours after the infarction (from 2% to 33%), in the surgery for myocardial revascularization (from 4% to 7%) and in the primary angioplasty (from 4% to 11%) with p=0.000, p=0.021, p=0.000 and p=0.000, respectively, for linear tendency. In the first 24 hours there was an increase of the use of aspirin and beta-blockers, from 78% to 100% and, from 33% to 76% (p=0.003 and p=0.004, respectively) along the years. After the analysis, the myocardial reperfusion therapy, the use of aspirin and beta-blocker in the first 24 hours of the AMI (p=0.010, p=0.024 and p=0.035, respectively) kept on being lethality determiners. There was a decrease in lethality and the change of behavior in the treatment of AMI along the years was responsible for the reduction of lethality in that temporal series.