Audit of acute myocardial infarctions at Saint James's Hospital, Dublin, from 1996 to 1999.
Saint James' Hospital is a 650-bed tertiary referral hospital. An audit was performed of acute transmural myocardial infarctions for the years 1996 to 1999 inclusive. On average there were 2043 cardiology admissions annually, 9.8% of all hospital admissions. Acute transmural myocardial infarction was diagnosed in 178 patients annually, and was less common during the summer. The figure of 72% receiving revascularisation therapy (thrombolysis 67%, primary angioplasty 5%) compares favourably with 35% in 1992. The main reason for not receiving thrombolysis was late presentation (15%) with contraindications present in only 5%. The case fatality rate was 16% confirming the higher mortality in clinical practice than that of thrombolytic trials. The prescription of aspirin or warfarin (99%) and betablockers (67%) was in line with international trials. The use of angiotensin converting enzyme inhibitors (34%) and statins (28%) is similar to other studies but less than would be expected according to trial evidence.
Pate
G E
GE
Department of Cardiology, CResT Directorate, Saint James' Hospital, Dublin 8.
Curtin
R
R
Talbot
A
A
Murphy
R T
RT
Ward
D
D
Barry
M
M
Crean
P
P
Foley
J B
JB
Walsh
M J
MJ
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000368:Aged; D017130:Angioplasty; D015906:Angioplasty, Balloon, Coronary; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D008297:Male; D008485:Medical Audit; D009203:Myocardial Infarction / Q000188:drug therapy* / Q000453:epidemiology / Q000601:surgery*; D009660:Northern Ireland / Q000453:epidemiology; D015912:Thrombolytic Therapy
D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D005343:Fibrinolytic Agents; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors