[Universal health coverage and accomplishment of secondary prevention goals among patients with acute myocardial infarction].
BACKGROUND
In 2005, acute myocardial infarction (AMI) was included in a universal health plan (GES) to reduce inequity in care and optimize its diagnosis and treatment.


OBJECTIVE
To evaluate the effect of GES in risk factor control and therapeutic management among patients with AMI.


METHODS
A survey was conducted in 2008-2009 in six public hospitals. Patients were identified from a hospital based registry of AMI and evaluated one year later with laboratory tests and an interview.


RESULTS
The registry enrolled 534 patients with ST and non ST segment elevation myocardial infarction. Of these, 416 patients aged 63 ± 12 years (25% women) were evaluated one year later. Eighty three percent were evaluated by a cardiologist and 37% by a general practitioner. Twenty two percent were evaluated by a nurse and 22% by a nutritionist. At the moment of the interview, 9% smoked, 78% were overweight or obese, 24% performed moderate or vigorous physical activity ≥ 150 min/week, 60% had systolic pressure > 130 mmHg and 63% a diastolic pressure > 80 mmHg. In 30%, LDL cholesterol was > 100 mg/dl and in 43%, triglycerides were > 150 mm/dl. Twenty two percent were diabetic and among them, 52% had a glycosylated hemoglobin > 7%. Forty five percent of non-diabetic patients had a fasting glucose > 100 mg/dl. Ninety three percent were in treatment with aspirin, 86% with statins, 66% with b-blockers, and 73% with angiotensin converting enzyme inhibitors or angiotensin receptor blockers and 20% with clopidogrel.


CONCLUSIONS
Despite the high proportion of patients in treatment with evidence-based therapy, many do not achieve the targets for risk factor control with the new health care model.
Carolina
C
Nazzal
Fernando
F
Lanas
María Luisa
ML
Garmendia
Claudio
C
Bugueño
Enrique
E
Mercadal
Eduardo
E
Garcés
Patricio
P
Yovaniniz
Patricio
P
Sanhueza
D000208:Acute Disease; D000368:Aged; D002677:Chile / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006779:Hospitals, Public; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy / Q000453:epidemiology / Q000517:prevention & control*; D015397:Program Evaluation; D012042:Registries / Q000706:statistics & numerical data; D012307:Risk Factors; D055502:Secondary Prevention / Q000379:methods*; D019472:Universal Health Insurance