title: Incidence, in-hospital case-fatality rates, and management practices in Puerto Ricans hospitalized with acute myocardial infarction.
abstract: OBJECTIVE
  There are extremely limited data on minority populations, especially Hispanics, describing the clinical epidemiology of acute coronary disease. The aim of this study is to examine the incidence rate of acute myocardial infarction (AMI), in-hospital case-fatality rate (CFR), and management practices among residents of greater San Juan (Puerto Rico) who were hospitalized with an initial AMI.
  
  
  METHODS
  Our trained study staff reviewed and independently validated the medical records of patients who had been hospitalized with possible AMI at any of the twelve hospitals located in greater San Juan during calendar year 2007.
  
  
  RESULTS
  The incidence rate (# per 100,000 population) of 1,415 patients hospitalized with AMI increased with advancing age and were significantly higher for older patients for men (198) than they were for women (134). The average age of the study population was 64 years, and women comprised 45% of the study sample. Evidence-based cardiac therapies, e.g., aspirin, beta blockers, ACE inhibitors/angiotensin receptor blockers, and statins, were used with 60% of the hospitalized patients, and women were less likely than men to have received these therapies (59% vs. 65%) or to have undergone interventional cardiac procedures (47% vs. 59%) (p<0.05). The in-hospital CFR increased with advancing age and were higher for women (8.6%) than they were for men (6.0%) (p<0.05).
  
  
  CONCLUSIONS
  Efforts are needed to reduce the magnitude of AMI, enhance the use of evidence-based cardiac therapies, reduce possible gender disparities, and improve the short-term prognoses of Puerto Rican patients hospitalized with an initial AMI.
authors.affiliation: University of Puerto Rico Medical Science Campus San Juan, Puerto Rico/Florida International University Herbert Wertheim College of Medicine, Miami, Florida, United States of America. juan.zevallos@fiu.edu
authors.forename: Juan C
authors.initials: JC
authors.lastname: Zevallos
authors.forename: Jorge
authors.initials: J
authors.lastname: Yarzebski
authors.forename: Juan A
authors.initials: JA
authors.lastname: González
authors.forename: Héctor L
authors.initials: HL
authors.lastname: Banchs
authors.forename: Mario
authors.initials: M
authors.lastname: García-Palmieri
authors.forename: Hernando
authors.initials: H
authors.lastname: Mattei
authors.forename: José
authors.initials: J
authors.lastname: Ayala
authors.forename: Marijesmar
authors.initials: M
authors.lastname: González
authors.forename: Vanessa
authors.initials: V
authors.lastname: Torres
authors.forename: Iris N
authors.initials: IN
authors.lastname: Ramos
authors.forename: Luis R
authors.initials: LR
authors.lastname: Pericchi
authors.forename: David A
authors.initials: DA
authors.lastname: Torres
authors.forename: María C
authors.initials: MC
authors.lastname: González
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Goldberg
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D006328:Cardiac Catheterization / Q000706:statistics & numerical data; D002317:Cardiovascular Agents / Q000627:therapeutic use; D015897:Comorbidity; D019468:Disease Management; D004363:Drug Utilization; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality / Q000517:prevention & control / Q000628:therapy; D009204:Myocardial Revascularization / Q000706:statistics & numerical data; D012307:Risk Factors; D017678:Sex Distribution; D063507:Sexism; D012959:Socioeconomic Factors; D014505:Urban Population / Q000706:statistics & numerical data
chemical_list: D002317:Cardiovascular Agents