[Reduction in 28 days and 6 months of acute myocardial infarction mortality from 1995 to 2005. Data from PRIAMHO I, II and MASCARA registries].

Introduction And Objectives: To determine whether mortality from acute myocardial infarction has reduced in Spain and the possibly related therapeutic factors.

Methods: Nine thousand, nine hundred and forty-nine patients with ST-segment elevation myocardial infarction admitted to the Coronary Care Unit were identified from PRIAMHO I, II and MASCARA registries performed in 1995, 2000 and 2005, with a 6 month follow-up.

Results: From 1995 to 2005 patients were increasingly more likely to have hypertension, hyperlipidemia and anterior infarction, but age of onset and the proportion of females did not increase.

Health-related quality of life as a prognostic factor of survival in critically ill patients.

Objective: To evaluate whether health-related quality of life prior to admission into an intensive care unit (ICU) is a prognostic factor of hospital and 1 year mortality.

Design: Prospective cohort study.

Setting: Fourteen-bed medical-surgical ICU.

[Reduction in acute myocardial infarction mortality over a five-year period].

Introduction And Objectives: To assess recent changes in the management of patients with acute myocardial infarction (AMI) and their impact on mortality using data from the PRIAMHO I and II registries (1995 and 2000).

Patients And Method: Of the 168 public hospitals in Spain, 24 and 58 contributed to the 1995 and 2000 PRIAMHO registries, respectively.

Results: Patients in the PRIAMHO II registry (n=6221) were significantly older, more often female, and proportionally more likely to have coronary risk factors or a previous myocardial infarction, or to have undergone revascularization than those in PRIAMHO I (n=5242).

[Effect of combined beta-blocker and angiotensin-converting enzyme inhibitor treatment on 1-year survival after acute myocardial infarction: findings of the PRIAMHO-II registry].

Introduction And Objectives: Clinical trials have shown that combining beta-blockers and angiotensin-converting enzyme (ACE) inhibitors has an additive effect in reducing mortality in patients with left ventricular dysfunction following acute myocardial infarction. Whether this additive effect also occurs in unselected post-myocardial infarction patients is unknown.

Methods: In total, 5397 patients who were discharged from hospital after suffering an acute myocardial infarction were followed for 1 year.

[Management of myocardial infarction in Spain in the year 2000. The PRIAMHO II study].

Introduction And Objectives: Hospital registries are useful tools to measure the degree of implementation of new treatments and clinical practice guidelines.

Patients And Method: The hospital registry described here was developed in the prospective PRIAMHO II study, which involved a random selection of Spanish hospitals with a coronary intensive care unit and external quality control. This study investigated patients admitted to the coronary care unit with acute myocardial infarction.

[Role of emergency departments in acute myocardial infarction care. EVICURE study].

No published information is available about myocardial infarction management in Spanish emergency departments. The EVICURE is a prospective, multicenter, observational study involving 35 hospitals that for a 3-week period collected all the cases of patients requiring care in which the final diagnosis of the cause of symptoms was ischemic heart disease. The study included 2,216 patients, of which 600 (27.

[2002 Update of the Guidelines of the Spanish Society of Cardiology for Unstable Angina/Without ST-Segment Elevation Myocardial Infarction].

Since the Spanish Society of Cardiology Clinical Practice Guidelines on Unstable Angina/Non-Q-Wave Myocardial Infarction were released in 1999, the conclusions of several studies that have been published make it advisable to update current clinical recommendations. The main findings are related to the developing role of Chest Pain Units in the management and early risk stratification of acute coronary syndromes in the emergency department; new information concerning the efficacy of glycoprotein IIb/IIIa inhibitors, clopidogrel and low-molecular-weight heparins in the pharmacological treatment of acute coronary syndromes without ST-segment elevation; and the role of early invasive strategy in improving the prognosis of these patients. The published evidence is reviewed and the corresponding clinical recommendations for the management of acute coronary syndromes without persistent ST-segment elevation are updated.

[Management of myocardial infarction in Spain (1995-99). Data from the registry of the Ischaemic Heart Disease Working Group (RISCI) of the Spanish Society of Cardiology].

Introduction And Objectives: Limited information is available on how patients with myocardial infarction are treated in Spain. In order to make up for this deficiency, in October 1994, the Ischaemic Heart Disease Working Group of the Spanish Society of Cardiology initiated a myocardial infarction registry, which is currently active.

Methods: Patients are recruited from hospitals with intensive coronary care facilities.

[The use of acetylsalicylic acid in patients with ischemic cardiomyopathy cared for in Spanish emergency services (results of the EVICURE Study). Evaluacion del Manejo de la cardiopatia isquemica en los Servicios de Urgencias Hospitalarios of the Sociedad Espanola de Medicina de Urgencias y Emergencias (SEMES)].

Background: Acetyl salicylic acid is a drug with demonstrated effectiveness in ischemic cardiomyopathy. The objective of our study was to know the use of this drug in the emergency services of Spain.

Patients And Method: The EVICURE study analyzes the use of acetyl salicylic acid in 35 emergency services of Spanish hospitals.

[Clinical practice guidelines of the Spanish Society of Cardiology on unstable angina/infarction without ST elevation].

This paper up-dates the Clinical Guidelines for Unstable Angina/Non Q wave Myocardial Infarction of the Spanish Society of Cardiology. Due to the increased efficacy of adequate management in the early phases, it has been considered necessary to include recommendations for the pre Hospital and Emergency department phase. Prehospital management.

[The clinical management guidelines of the Sociedad Española de Cardiología in acute myocardial infarct].

In the recent years, new possibilities have emerged in the diagnosis and management of acute myocardial infarction with ST segment elevation and its complications. Moreover, a deep transformation has taken place in the health care system organization, particularly in aspects related to care of patients presenting non-traumatic chest pain, both in pre-hospital and hospital areas. All these issues warrant a consensus document in Spain dealing with the role that these important changes should play in the whole management of myocardial infarction patients.

[Variability in the management and prognosis at short- and medium-term of myocardial infarct in Spain: the PRIAMHO study. Registration Project of Hospital Acute Myocardial Infarct].

Background And Purpose: The paucity of data on myocardial infarction management and results in Spain lead to the design of the PRIAMHO study (Proyecto de Registro de Infarto Agudo de Miocardio Hospitalario [Acute Myocardial Infarction Hospital Registration Project]) which developed standard methods to collect information on the management of patients with such a condition and their characteristics. The variability results among hospitals in myocardial infarction management and in one-year mortality are presented.

Methods: A cohort study with a one-year follow-up was designed to register all patients diagnosed with acute myocardial infarction discharged from 24 Spanish hospitals that completed all the requisites to participate.

[Diagnosis of unstable angina in the emergency room. The clinical value and limitations of electrocardiography and other tests].

The quick and accurate diagnosis of acute coronary heart disease in the emergency department constitutes a first line medical challenge. About 5% of patients attending to the emergency department present chest pain or symptoms suggesting myocardial ischemia. A prompt diagnosis contributes to patient survival while an incorrect one can be associated to an increased risk of unfavorable outcome.

[Therapy with glucose-insulin-potassium reduces the complications in the acute phase of myocardial infarct. Arguments against].

Glucose-insulin-potassium therapy has shown its efficacy in diminishing the myocardial damage under ischemia-reperfusion conditions in experimental models. This effect appears to be mainly due to the increase of anaerobic glycolysis in ischemic cells with a consequent reduction in the use of fatty acids. On the other hand, clinical studies in the acute phase of myocardial infarction are out-dated and almost non-existent in the thrombolytic era.

[Stratification of arrhythmia risk and therapeutic options in survivors of acute myocardial infarction].

A significant improvement in late survival of post-myocardial infarction patients has been observed during the last few years, even before the beginning of the thrombolytic era. However, about half of the fatality rate in these patients is related to arrhythmic sudden death. So, a discussion of the value of different diagnostic and therapeutic tools available for reducing arrhythmic risk seems pertinent.

[Evaluation of home physical training soon after acute myocardial infarction].

Little attention has been directed to the utility of unsupervised physical training at home in postmyocardial infarction patients. The present investigation was designed to assess the effects of exercise training at home on functional parameters soon after myocardial infarction. One hundred and eighteen male postmyocardial infarction patients under 70 years old, that performed a predischarge exercise test, were randomly allocated soon after the acute event, into a 12-14 weeks unsupervised physical training at home and into a control group.

[The cardiology consultation in a health-service area hospital. The clinical aspects and the demand for diagnostic procedures].

Four consecutive years (1987-1990) outpatients attendance at a cardiology clinic was recorded in a district hospital with a catchment area of 200,000 inhabitants. The aim being to identify and evaluate the demand for cardiology consultations. A system for recording diagnoses was developed, based on the WONCA.