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• W2095571214 abstract "En España existe escasa información sobre la variabilidad interhospitalaria en el tratamiento del infarto agudo de miocardio (IAM) y su evolución temporal. El objetivo de este trabajo es describir el coeficiente de variabilidad (CV) y su evolución en la utilización de trombolíticos, aspirina (AAS), bloqueadores beta e inhibidores de la enzima conversiva de la angiotensina (IECA) en los hospitales del registro PRIMVAC. El registro PRIMVAC recoge de forma prospectiva los pacientes dados de alta con el diagnóstico de IAM de las unidades coronarias de 17 hospitales de la Comunidad Valenciana. Se describe el CV (desviación estándar/media × 100)de los fármacos considerados y su evolución en 12 hospitales que permanecieron ininterrumpidamente en el PRIMVAC entre el 1 de enero de 1995 y el 31 de diciembre de 1998. Existen amplias variaciones interhospitalarias en el uso de los fármacos analizados, con un CV que, salvo para el AAS, supera el 20%. En el período de 4 años no se observaron cambios significativos en las características del IAM. En este período el CV mostró una tendencia a disminuir en los trombolíticos (31,8 frente a 22,8%), IECA (63,4 frente a 55,4%) y bloqueadores beta (74,31 frente a 65,3%). El uso de los trombolíticos (42,5 frente a 49%; p < 0,0001), AAS (88 frente a 90,4%; p < 0,01) y IECA (27,2 frente a 39,8%; p > 0,0001) se incrementó significativamente. En los hospitales del PRIMVAC existe una importante variabilidad en el uso de los fármacos recomendados en el tratamiento del IAM. Esta variabilidad se atenúa en la evolución temporal del tratamiento, en la que se observa una tendencia acorde con las recomendaciones de las Sociedades Científicas. Data about hospital differences in acute myocardial infarction (AMI) management are scarce in Spain. The aim of this study is to describe the variability in the use of thrombolytic therapy, aspirine (AAS), beta-blockers and angiotensin converting enzyme inhibitors (ACEI) in the management of AMI, and the changes observed along a 4-year period among 12 hospitals participating in the PRIMVAC registry. The PRIMVAC registry includes all the patients discharged from the coronary care units of 17 hospitals of the Valencian Community (Spain) diagnosed of AMI. The variability ratio (standard deviation/mean) of the considered drugs and its temporary evolution were analyzed in the 12 hospitals which remained in the PRIMVAC registry from January 1995 to December 1998. A large variability in the use of the analyzed drugs was observed with a variability ratio > 20%, except for AAS. Along the 4-year period this ratio showed a trend to decrease in thrombolysis (31.8 vs 22.8%), ACEI (63.4 vs 55.4%) and beta-blockers (74.3 vs 65.3%). The use of thrombolytic therapy (42.5 vs 49%; p < 0.0001), AAS (88 vs 90,4%; p < 0.01) and ACEI (27.2 vs 39.8); p < 0.0001) increased significantly. A considerable variability in the use of the drugs recommended in the treatment of AMI occurred in the PRIMVAC registry. This variability decreased along a 4-year period in which we observed a trend in the management of AMI which agrees with the recommendations of the task forces of the societies of cardiology." @default.
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• W2095571214 date "2001-01-01" @default.
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• W2095571214 title "Variabilidad y evolución del tratamiento del infarto agudo de miocardio en el estudio PRIMVAC (Proyecto de Registro de Infarto Agudo de Miocardio de Valencia, Alicante y Castellón)" @default.
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• W2095571214 doi "https://doi.org/10.1016/s0210-5691(01)79660-x" @default.
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