title: [The role of Italian cardiology in the Italian Group for the Study of Streptokinase in Myocardial Infarct. Distribution, structural and organizational characteristics of coronary intensive care units].
abstract: After a short "historical" mention of the fundamental stages that produced the protocol and the beginning of the G.I.S.S.I. study, we examine the statistics on the organizing, epidemiological and therapeutic aspects observed during the G.I.S.S.I. study. Even if the collected data are referred only to the 176 CCU participating in the G.I.S.S.I., and the results on mortality and hospitalization time takes into account only the myocardial infarctions randomized for the study, and the criteria used in the analysis (organizational and structural parameters) are considered arbitrary, we underline the evident lack of balance in the geographic distribution of the CCU; this imbalance involves also the instrumental equipment. Furthermore we note a poor, but significative, decrease in the mortality of the Units with a higher hospitalization/year and with a more sophisticated instrumental equipment. Another interesting data, from a clinical and organizational point of view, concerns the high number of patients--10210 out of 20020 (51%)--excluded from the randomization, because hospitalized after 12 hours. This data underlines the big problem of the "pre-coronary" time, which is still to long, actually, in our country. These data must induce to increase the efforts to develop the network of CCU in our Country and to inform the people and the sanitary operators about the usefulness of quicker therapeutic intervention. From an epidemiological investigation, the best results were obtained in the patients hospitalized within the first few hours from the onset of the symptoms.
mesh_terms: D002986:Clinical Trials as Topic; D003325:Coronary Care Units / Q000458:organization & administration* / Q000706:statistics & numerical data; D006742:Hospital Bed Capacity; D006801:Humans; D007558:Italy; D007902:Length of Stay; D009203:Myocardial Infarction / Q000188:drug therapy* / Q000401:mortality; D013300:Streptokinase / Q000627:therapeutic use
chemical_list: D013300:Streptokinase
vernacular_title: Il ruolo della Cardiologia Italiana nella realizzazione del G.I.S.S.I. Distribuzione, caratteristiche strutturali e organizzative delle UCIC.