A prospective national survey of management and clinical outcome of acute myocardial infarction in Israel, 2000

Little information is available on the clinical practice and implementation of guidelines for treating acute myocardial infarction patients in Israel. To assess patient characteristics, hospital course, management, and 30 day clinical outcome of all AMI patients hospitalized in Israel during a 2 mon...

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Bibliographic Details
Published in:The Israel Medical Association journal 2003-04, Vol.5 (4), p.249-254
Main Authors: Behar, Solomon, Battler, Alexander, Porath, Avi, Leor, Jonathan, Grossman, Ehud, Hasin, Yonathan, Mittelman, Moshe, Feigenberg, Zvi, Rahima-Maoz, Carmit, Green, Manfred, Caspi, Avraham, Rabinowitz, Babeth, Garty, Moshe
Format: Article
Language:English
Subjects:
Aged
Electrocardiography
Female
Guideline Adherence
Health Care Surveys
Humans
Israel
Male
Middle Aged
Myocardial Infarction - complications
Myocardial Infarction - therapy
Practice Guidelines as Topic
Prospective Studies
Registries
Treatment Outcome
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Summary:Little information is available on the clinical practice and implementation of guidelines for treating acute myocardial infarction patients in Israel. To assess patient characteristics, hospital course, management, and 30 day clinical outcome of all AMI patients hospitalized in Israel during a 2 month period in 2000. We conducted a prospective 2 month survey of consecutive AMI patients admitted to 82 of 96 internal medicine departments and all 26 cardiac departments operating in Israel in 2000. Data were collected uniformly by means of a hospital and 30 day follow-up form. During the survey 1,683 consecutive patients with a discharge diagnosis of AMI were included. Their mean age was 66 years; 73% were male. The electrocardiographic pattern on admission revealed ST elevation, non-ST elevation and an undetermined ECG in 63%, 34% and 4% of patients respectively. Aspirin and heparin were given to 95% of patients. Beta-blockers and angiotensin-converting enzyme inhibitors were given to 76% and 65% of patients respectively. Among hospital survivors, 45% received lipid-lowering drugs. Thrombolytic therapy was administered in 28% of patients, coronary angiography was used in 45%, and 7% of patients underwent primary percutaneous coronary intervention. The 7 and 30 day mortality rates were 7% and 11% respectively. This nationwide survey shows that one-third of the AMI patients in Israel are elderly (> or = 75 years). The survey suggests that clinical guidelines for the management of patients with AMI are partially implemented in the community. Data from large surveys representing the "real world" practice are of utmost importance for the evaluation of clinical guidelines, research and educational purposes.
ISSN:1565-1088