Acute myocardial infaction: results from the SAC 2005 survey in the Argentine Republic

Introduction: Considering that the acute myocardial infarction (AMI) is the most frequent cause of death in our country, this multicentric registry intends to establish a vision of the epidemiological reality (limited to the participating sites) aimed at obtaining information in regards to the clinical management and in-hospital morbi-mortality. Objective: To analyze the epidemiological, clinical, therapeutic uses and mortality in AMI in sites affiliated to the Argentine society of Cardiology. Material and Methods: Five hundred and fifteen patients from 74 intensive care units throughout the country, registered during 2 consecutive months, within the period April-December 2005. Results: The median age was 62 years; 24% were women. Six percent did no show any risk factor where as 38% had at least three factors. 27.9% of the patients had a history of some type of coronary disease. 65.4% were admitted within the first 6 hours; in 42.2% AMI location was anterior, with Killip and Kimball A in 77.6% of the patients. Upon admission, 74.8% showed supra imbalance of the ST segment and 4.9% LBBB. 53% underwent reperfusion therapy (42.3% thrombolytic therapy and 57.7% primary angioplasty), 80.3% if we include patients eligible for reperfusion therapy (n=320). The most frequent complication was cardiac failure that reached 20.2% whereas 11.3% showed post infarct angina and 4.3% reinfarction. In-Hospital mortality was 12.6%. At discharge, 95.1% were administered aspirin, 78.8% beta blockers, 72.8% statins, and 55.9% clopidogrel. Conclusions: Still, an important range of patients eligible for reperfusion does not receive it. Primary angioplasty was the reperfusion strategy mostly administered; probably related to the characteristics of the participating sites. We considered that the efforts should be focused on the strategies that most likelywill translate in increased benefits.