title: [Study of early response to cases of acute myocardial infarction in primary care].
abstract: OBJECTIVE
  To discover the present role of Primary Care (PC) in the early response to Acute Myocardial Infarction (AMI) in a health area, defining the diagnostic and therapeutic measures employed and whether these cause delay in thrombolytic treatment.
  
  
  METHODS
  Prospective, observational study of cohorts.
  
  
  METHODS
  Casualty departments at the primary and hospital levels.
  
  
  METHODS
  All AMI patients admitted to the only Intensive Therapy Unit (ITU) in a health area over a three-month period (No. = 28).
  
  
  RESULTS
  The patients were divided into two groups, defined by whether they had attended PC or hospital. The time elapsed before ITU admission, and the diagnostic methods and treatments in PC were investigated. Nine patients (32%) attended PC and 19 (67%), hospital. The average delay was 6.7 hours. The percentage of patients who were admitted to the ITU before four hours had elapsed was higher for those who had previously attended PC (p < 0.05; Chi squared, Yates correction). In PC neither ECG, nor anti-aggregants nor analgesics were used in any of the cases. Nitrites were used on 4 patients (44%).
  
  
  CONCLUSIONS
  Patients with AMI preferred to go directly to hospital. Initial care in PC did not necessarily lead to any delay in the thrombolysis: indeed it led to a higher percentage of admissions during the first four hours. There was insufficient use of diagnostic procedures and drugs in the initial stage of AMI in PC.
authors.affiliation: Hospital de Sagunto.
authors.forename: J M
authors.initials: JM
authors.lastname: Soler Torró
authors.forename: C
authors.initials: C
authors.lastname: Momparler-Martínez
authors.forename: C
authors.initials: C
authors.lastname: Tormo Calandín
mesh_terms: D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000628:therapy*; D011320:Primary Health Care / Q000592:standards*; D011446:Prospective Studies; D013030:Spain; D015912:Thrombolytic Therapy
vernacular_title: Estudio de la atención inicial a pacientes con infarto aguto de miocardio en atención primaria.