Time trends in the treatment of acute myocardial infarction in Switzerland from 1986 to 1993 : Do they reflect the advances in scientific evidence from clinical trials ?
Three acute coronary care surveys (1986,1990, and 1993) were conducted in the Swiss region of Vaud-Fribourg on all men aged 25 to 64 years hospitalized for a definite myocardial infarction (218,224, and 167 cases).
Nearly all patients received anticoagulants and nitrates.
The proportion of patients treated increased significantly, between 1986 and 1990, for antiplatelet drugs (from 51% to 96%) and thrombolytics (from 9% to 44%) and, between 1990 and 1993, for beta-blockers (from 57% to 78%) and angiotensin-converting enzyme inhibitors (from 26% to 43%). The use of calcium antagonists and antiarrhythmics dropped over time.
Coronary arteriography and angioplasty were increasingly performed (53% and 18% in 1993), although progressively postponed in-hospital stay.
The observed trends reflect a rapid translation of clinical trials into medical practice.
However the use of thrombolytics could be raised further by shortening the hospitalization delay (median : 3 hours in 1993) and door-to-needle time (median : 47 minutes) which remained stable over time.
Mots-clés Pascal : Infarctus, Myocarde, Evolution, Variation temporelle, Epidémiologie, Chimiothérapie, Traitement, Efficacité traitement, Homme, Suisse, Europe, Appareil circulatoire pathologie, Cardiopathie coronaire, Myocarde pathologie
Mots-clés Pascal anglais : Infarct, Myocardium, Evolution, Time variation, Epidemiology, Chemotherapy, Treatment, Treatment efficiency, Human, Switzerland, Europe, Cardiovascular disease, Coronary heart disease, Myocardial disease
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0453495
Code Inist : 002B12A03. Création : 25/01/1999.