title: Prevalence of comorbidities and their impact on hospital management and short-term outcomes in Vietnamese patients hospitalized with a first acute myocardial infarction.
abstract: BACKGROUND
  Cardiovascular disease is one of the leading causes of morbidity and mortality in Vietnam. We conducted a pilot study of Hanoi residents hospitalized with a first acute myocardial infarction (AMI) at the Vietnam National Heart Institute in Hanoi for purposes of describing the prevalence of cardiovascular (CVD) and non-CVD comorbidities and their impact on hospital management, in-hospital clinical complications, and short-term mortality in these patients.
  
  
  METHODS
  The study population consisted of 302 Hanoi residents hospitalized with a first AMI at the largest tertiary care medical center in Hanoi in 2010.
  
  
  RESULTS
  The average age of study patients was 66 years and one third were women. The proportions of patients with none, any 1, and ≥ 2 CVD comorbidities were 34%, 42%, and 24%, respectively. Among the CVD comorbidities, hypertension was the most commonly reported (59%). There were decreasing trends in the proportion of patients who were treated with effective cardiac medications and coronary interventions as the number of CVD comorbidities increased. Patients with multiple CVD comorbidities tended to develop acute clinical complications and die at higher rates during hospitalization compared with patients with no CVD comorbidities (Odds Ratio: 1.40; 95% Confidence Interval: 0.40-4.84).
  
  
  CONCLUSIONS
  Our data suggest that patients with multiple cardiac comorbidities tended to experience high in-hospital death rates in the setting of AMI. Full-scale surveillance of Hanoi residents hospitalized with AMI at all Hanoi hospitals is needed to confirm these findings. Effective strategies to manage Vietnamese patients hospitalized with AMI who have multiple comorbidities are warranted to improve their short-term prognosis.
authors.affiliation: Institute of Population, Health and Development, Ha Noi, Viet Nam; Oxford University Clinical Research Unit, Ho Chi Minh City, Viet Nam.
authors.forename: Hoa L
authors.initials: HL
authors.lastname: Nguyen
authors.affiliation: Viet Nam National Heart Institute, Ha Noi, Viet Nam.
authors.forename: Quang Ngoc
authors.initials: QN
authors.lastname: Nguyen
authors.affiliation: Ministry of Health, Ha Noi, Viet Nam.
authors.forename: Duc Anh
authors.initials: DA
authors.lastname: Ha
authors.affiliation: Viet Nam National Heart Institute, Ha Noi, Viet Nam.
authors.forename: Dat Tuan
authors.initials: DT
authors.lastname: Phan
authors.affiliation: Institute of Population, Health and Development, Ha Noi, Viet Nam.
authors.forename: Nguyen Hanh
authors.initials: NH
authors.lastname: Nguyen
authors.affiliation: Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts, United States of America.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Goldberg
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D015897:Comorbidity; D005260:Female; D006739:Hospital Administration; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology* / Q000628:therapy*; D010865:Pilot Projects; D015995:Prevalence; D011379:Prognosis; D016896:Treatment Outcome; D014744:Vietnam / Q000453:epidemiology