Acute coronary care and treatment of myocardial infarction in the three French MONICA registers.
The study evaluates and compares among the three French MONICA centres the access to emergency care, and the treatment administered to 1444 patients aged 25-64 years hospitalized for an acute coronary event. It was carried out in 1985 in Bas-Rhin (BR) on 596 subjects, in 1986 in Haute-Garonne (HG) on 450 subjects, and from October 1986 to July 1987 in the Urban Community of Lille (UCL) on 395 subjects. The time before receiving initial medical care could be analysed only in BR and HG: it is shorter in HG (p less than 0.001). Patients with a history of coronary disease are inclined to consult more quickly than patients with a first event (p less than 0.001). According to the three centres, 68.5 to 72.5% of the patients consult first a private practitioner, while 9 to 10.5% contact first a mobile team (mobile emergency care unit), and 6 to 15% go directly to hospital. Patients with a previous history tend more to call a mobile team directly, or to go to hospital directly than patients without a history (p less than 0.001). The analysis of the treatment was made only on patients classified in MONICA diagnostic category 1: the therapeutic schemes are similar in the three centres, although differences are noted in the frequency of prescription. The use of new medications and procedures seems to be best established in HG and in UCL than in BR, with the reservation that the three studies were not conducted at the same time.
Arveiler
D
D
Projet MONICA Bas-Rhin, Faculté de Médecine, Strasbourg, France.
Cambou
J P
JP
Nuttens
M C
MC
Bingham
A
A
Hedelin
G
G
Ruidavets
J B
JB
Richard
J L
JL
Salomez
J L
JL
Sacrez
A
A
Schaffer
P
P
D000328:Adult; D000800:Angioplasty, Balloon / Q000379:methods; D002317:Cardiovascular Agents / Q000627:therapeutic use; D017023:Coronary Angiography; D003327:Coronary Disease / Q000628:therapy*; D004632:Emergency Medical Services; D005260:Female; D005602:France / Q000453:epidemiology; D006760:Hospitalization; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000628:therapy*; D013997:Time Factors
D002317:Cardiovascular Agents