Department of Quantitative Health Sciences
Medical Subject Headings
Adult; Age Distribution; Aged; Aged, 80 and over; Cardiac Catheterization; Cardiovascular Agents; Comorbidity; Disease Management; Drug Utilization; Female; Hospital Mortality; Humans; Incidence; Male; Middle Aged; Myocardial Infarction; control; Myocardial Revascularization; Risk Factors; Sex Distribution; Sexism; Socioeconomic Factors; Urban Population
Cardiology | Cardiovascular Diseases | Clinical Epidemiology | Community-Based Research | Health Services Administration
OBJECTIVE: There are extremely limited data on minority populations, especially Hispanics, describing the clinical epidemiology of acute coronary disease. The aim of this study is to examine the incidence rate of acute myocardial infarction (AMI), in-hospital case-fatality rate (CFR), and management practices among residents of greater San Juan (Puerto Rico) who were hospitalized with an initial AMI.
METHODS: Our trained study staff reviewed and independently validated the medical records of patients who had been hospitalized with possible AMI at any of the twelve hospitals located in greater San Juan during calendar year 2007.
RESULTS: The incidence rate (# per 100,000 population) of 1,415 patients hospitalized with AMI increased with advancing age and were significantly higher for older patients for men (198) than they were for women (134). The average age of the study population was 64 years, and women comprised 45% of the study sample. Evidence-based cardiac therapies, e.g., aspirin, beta blockers, ACE inhibitors/angiotensin receptor blockers, and statins, were used with 60% of the hospitalized patients, and women were less likely than men to have received these therapies (59% vs. 65%) or to have undergone interventional cardiac procedures (47% vs. 59%) (p < 0.05). The in-hospital CFR increased with advancing age and were higher for women (8.6%) than they were for men (6.0%) (p < 0.05).
CONCLUSION: Efforts are needed to reduce the magnitude of AMI, enhance the use of evidence-based cardiac therapies, reduce possible gender disparities, and improve the short-term prognoses of Puerto Rican patients hospitalized with an initial AMI.
community-based surveillance, acute myocardial infarction, incidence
Zevallos, Juan C.; Yarzebski, Jorge L.; Gonzalez, Juan A.; Banchs, Hector L.; Garcia-Palmieri, Mario; Mattei, Hernando; Ayala, Jose; Gonzalez, Marijesmar; Torres, Vanessa; Ramos, Iris N.; Pericchi, Luis R.; Torres, David A.; Gonzalez, Maria C.; and Goldberg, Robert J., "Incidence, in-hospital case-fatality rates, and management practices in Puerto Ricans hospitalized with acute myocardial infarction" (2013). University of Massachusetts Medical School Faculty Publications. 614.
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