Prevención secundaria post infarto agudo de miocardio en hospitales públicos: implementación y resultados de las garantías GES

Background: In 2005, acute myocardial infarction (AMI) was included in a universal health plan (GES) to reduce inequity in care and optimize its diagnosis and treatment. Aim: To evaluate the effect of GES in risk factor control and therapeutic management among patients with AMI. Material and Methods...

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Autores principales:	Nazzal,Carolina, Lanas,Fernando, Garmendia,María Luisa, Bugueño,Claudio, Mercadal,Enrique, Garcés,Eduardo, Yovaniniz,Patricio, Sanhueza,Patricio
Lenguaje:	Spanish / Castilian
Publicado:	Sociedad Médica de Santiago 2013
Materias:	Anterior wall myocardial infarction Chile Practice guideline Quality of health care Secondary prevention Universal coverage
Acceso en línea:	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872013000800003
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spelling	oai:scielo:S0034-988720130008000032014-01-27Prevención secundaria post infarto agudo de miocardio en hospitales públicos: implementación y resultados de las garantías GESNazzal,CarolinaLanas,FernandoGarmendia,María LuisaBugueño,ClaudioMercadal,EnriqueGarcés,EduardoYovaniniz,PatricioSanhueza,Patricio Anterior wall myocardial infarction Chile Practice guideline Quality of health care Secondary prevention Universal coverage Background: In 2005, acute myocardial infarction (AMI) was included in a universal health plan (GES) to reduce inequity in care and optimize its diagnosis and treatment. Aim: To evaluate the effect of GES in risk factor control and therapeutic management among patients with AMI. Material and Methods: A survey was conducted in 2008-2009 in six public hospitals. Patients were identified from a hospital based registry of AMI and evaluated one year later with laboratory tests and an interview. Results: The registry enrolled 534 patients with ST and non ST segment elevation myocardial infarction. Of these, 416 patients aged 63 ± 12 years (25% women) were evaluated one year later. Eighty three percent were evaluated by a cardiologist and 37% by a general practitioner. Twenty two percent were evaluated by a nurse and 22% by a nutritionist. At the moment of the interview, 9% smoked, 78% were overweight or obese, 24% performed moderate or vigorous physical activity ≥ 150 min/week, 60% had systolic pressure > 130 mmHg and 63% a diastolic pressure > 80 mmHg. In 30%, LDL cholesterol was > 100 mg/dl and in 43%, triglycerides were > 150 mm/dl. Twenty two percent were diabetic and among them, 52% had a glycosilated hemoglobin > 7%. Forty five percent of non-diabetic patients had a fasting glucose > 100 mg/dl. Ninety three percent were in treatment with aspirin, 86% with statins, 66% with b-blockers, and 73% with angiotensin converting enzyme inhibitors or angiotensin receptor blockers and 20% with clopidogrel. Conclusions: Despite the high proportion of patients in treatment with evidence-based therapy, many do not achieve the targets for risk factor control with the new health care model.info:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.141 n.8 20132013-08-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872013000800003es10.4067/S0034-98872013000800003
institution	Scielo Chile
collection	Scielo Chile
language	Spanish / Castilian
topic	Anterior wall myocardial infarction Chile Practice guideline Quality of health care Secondary prevention Universal coverage
spellingShingle	Anterior wall myocardial infarction Chile Practice guideline Quality of health care Secondary prevention Universal coverage Nazzal,Carolina Lanas,Fernando Garmendia,María Luisa Bugueño,Claudio Mercadal,Enrique Garcés,Eduardo Yovaniniz,Patricio Sanhueza,Patricio Prevención secundaria post infarto agudo de miocardio en hospitales públicos: implementación y resultados de las garantías GES
description	Background: In 2005, acute myocardial infarction (AMI) was included in a universal health plan (GES) to reduce inequity in care and optimize its diagnosis and treatment. Aim: To evaluate the effect of GES in risk factor control and therapeutic management among patients with AMI. Material and Methods: A survey was conducted in 2008-2009 in six public hospitals. Patients were identified from a hospital based registry of AMI and evaluated one year later with laboratory tests and an interview. Results: The registry enrolled 534 patients with ST and non ST segment elevation myocardial infarction. Of these, 416 patients aged 63 ± 12 years (25% women) were evaluated one year later. Eighty three percent were evaluated by a cardiologist and 37% by a general practitioner. Twenty two percent were evaluated by a nurse and 22% by a nutritionist. At the moment of the interview, 9% smoked, 78% were overweight or obese, 24% performed moderate or vigorous physical activity ≥ 150 min/week, 60% had systolic pressure > 130 mmHg and 63% a diastolic pressure > 80 mmHg. In 30%, LDL cholesterol was > 100 mg/dl and in 43%, triglycerides were > 150 mm/dl. Twenty two percent were diabetic and among them, 52% had a glycosilated hemoglobin > 7%. Forty five percent of non-diabetic patients had a fasting glucose > 100 mg/dl. Ninety three percent were in treatment with aspirin, 86% with statins, 66% with b-blockers, and 73% with angiotensin converting enzyme inhibitors or angiotensin receptor blockers and 20% with clopidogrel. Conclusions: Despite the high proportion of patients in treatment with evidence-based therapy, many do not achieve the targets for risk factor control with the new health care model.
author	Nazzal,Carolina Lanas,Fernando Garmendia,María Luisa Bugueño,Claudio Mercadal,Enrique Garcés,Eduardo Yovaniniz,Patricio Sanhueza,Patricio
author_facet	Nazzal,Carolina Lanas,Fernando Garmendia,María Luisa Bugueño,Claudio Mercadal,Enrique Garcés,Eduardo Yovaniniz,Patricio Sanhueza,Patricio
author_sort	Nazzal,Carolina
title	Prevención secundaria post infarto agudo de miocardio en hospitales públicos: implementación y resultados de las garantías GES
title_short	Prevención secundaria post infarto agudo de miocardio en hospitales públicos: implementación y resultados de las garantías GES
title_full	Prevención secundaria post infarto agudo de miocardio en hospitales públicos: implementación y resultados de las garantías GES
title_fullStr	Prevención secundaria post infarto agudo de miocardio en hospitales públicos: implementación y resultados de las garantías GES
title_full_unstemmed	Prevención secundaria post infarto agudo de miocardio en hospitales públicos: implementación y resultados de las garantías GES
title_sort	prevención secundaria post infarto agudo de miocardio en hospitales públicos: implementación y resultados de las garantías ges
publisher	Sociedad Médica de Santiago
publishDate	2013
url	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872013000800003
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Prevención secundaria post infarto agudo de miocardio en hospitales públicos: implementación y resultados de las garantías GES

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