CLINICAL PROFILE AND MANAGEMENT OF PATIENTS WITH INCIDENT AND RECURRENT ACUTE MYOCARDIAL INFARCTION IN ALBANIA - A CALL FOR MORE FOCUS ON PREVENTION STRATEGIES: KLINIČNI PROFIL IN ZDRAVLJENJE PACIENTOV S PRVIM IN PONOVNIM POJAVOM AKUTNEGA MIOKARDNEGA INFARKTA V ALBANIJI – POZIV ZA VEČJO POZORNOST NA PODROČJU PREVENTIVNIH STRATEGIJ

Sokol Myftiu, Enxhela Sulo, Genc Burazeri, Bledar Daka, Ilir Sharka, Artan Shkoza, Gerhard Sulo*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

2 Citations (Web of Science)

Abstract

Background. The clinical profile of acute myocardial infarction (AMI) patients reflects the burden of risk factors in the general population. Differences between incident (first) and recurrent (repeated) events and their impact on treatment are poorly described. We studied potential differences in the clinical profile and in-hospital treatment between patients hospitalised with an incident and recurrent AMI.

Methods. A total of 324 patients admitted in the Coronary Care Unit of 'Mother Teresa' hospital, Tirana, Albania (2013-2014), were included in the study. Information on AMI type, complications and risk factors was obtained from patient's medical file. Logistic regression analyses were used to explore differences between the incident and recurrent AMIs regarding clinical profile and in-hospital treatment.

Results. Of all patients, 50 (15.4%) had a prior AMI. Compared to incident cases, recurrent cases were older (P=0.01), more often women (P=0.01), less educated (P=0.01), and smoked less (P=0.03). Recurrent cases experienced more often heart failure (HF) (OR=2.48; 95% CI: 1.31-4.70), impaired left ventricular ejection fraction (OR=1.97; 95% CI: 1.05-3.71), and multivessel disease (OR=6.32; 95% CI: 1.43-28.03) than incident cases. In-hospital use of beta-blockers was less frequent among recurrent compared to incident cases (OR=0.45; 95% CI: 0.24-0.85), while no statistically significant differences between groups were observed regarding angiotensin-converting enzyme inhibitor/angiotensin receptor blocker, statin, aspirin or invasive procedures.

Conclusion. A more severe clinical expression of the disease and underutilisation of treatment among recurrent AMIs are likely to explain their poorer prognosis compared to incident AMIs.

Original languageEnglish
Pages (from-to)236-243
Number of pages8
JournalZdravstveno Varstvo
Volume56
Issue number4
DOIs
Publication statusPublished - Dec 2017

Keywords

  • acute myocardial infarction
  • epidemiology
  • in-hospital treatment
  • prevention
  • Albania
  • CORONARY-HEART-DISEASE
  • POPULATION-BASED SURVEY
  • CONVENTIONAL RISK-FACTORS
  • CARDIOVASCULAR-DISEASE
  • TIRANA CITY
  • MORTALITY-RATES
  • EVENT RATES
  • TRANSITION
  • COUNTRY
  • TRENDS

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