title: [Can we improve the management of acute coronary syndromes in primary care?].
abstract: OBJECTIVE
  To evaluate a training programme in the primary care of acute coronary syndrome.
  
  
  METHODS
  A before-during-after comparative cross-sectional study.
  
  
  METHODS
  Health areas of Lleida, High Pyrenees and Aran (Spain), from 2003-2006.
  
  
  METHODS
  Patients with acute coronary syndrome admitted to the intensive medicine unit and the coronary unit of the Arnau de Vilanova University Hospital of Lleida after being referred from home, general practitioner or health centre.
  
  
  METHODS
  A training program was introduced to establish protocols of pre-hospital performance in acute coronary syndrome (the administration of acetylsalicylic acid, nitroglycerin and morphine chloride, the performing of an electrocardiogram, the insertion of an intravenous tube and to speed up care times).
  
  
  METHODS
  Linear trend of the three periods of the study was analyzed through prevalences ratio and linear trend test.
  
  
  RESULTS
  The intervention showed a statistically significant linear increase in the application of the aforementioned therapeutic procedures, with the exception of nitroglycerin, which started out with a higher baseline level, and an improvement of care times. The application of an electrocardiogram obtained almost optimal levels. Care times considerably improved.
  
  
  CONCLUSIONS
  Training programs are a useful tool in improving treatment of acute coronary syndromes in primary care. Advance diagnosis and an early start to treatment almost certainly results in a decrease of its morbidity-mortality.
authors.affiliation: Servicio de Cardiología, Hospital Universitari Arnau de Vilanova, Institut de Recerca Biomèdica (IRB), Lleida, Spain. mpique@comll.cat
authors.forename: Manuel
authors.initials: M
authors.lastname: Piqué
authors.forename: Joan
authors.initials: J
authors.lastname: Torres
authors.forename: Begoña
authors.initials: B
authors.lastname: Balsera
authors.forename: Isabel
authors.initials: I
authors.lastname: Hernández
authors.forename: Antonio
authors.initials: A
authors.lastname: Miñano
authors.forename: Fernando
authors.initials: F
authors.lastname: Worner
mesh_terms: D054058:Acute Coronary Syndrome / Q000628:therapy*; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D011320:Primary Health Care / Q000592:standards*