Prevención secundaria post infarto agudo de miocardio en hospitales públicos: implementación y resultados de las garantías GES
| Autor: | María Luisa Garmendia, Enrique Mercadal, Patricio Yovaniniz, Claudio Bugueño, Eduardo Garcés, Patricio Sanhueza, Carolina Nazzal, Fernando Lanas |
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| Rok vydání: | 2013 |
| Předmět: |
Practice guideline
medicine.medical_specialty Overweight Internal medicine medicine ST segment Myocardial infarction Chile Risk factor Aspirin biology business.industry Secondary prevention Anterior wall myocardial infarction Angiotensin-converting enzyme General Medicine Clopidogrel medicine.disease Surgery Blood pressure biology.protein Quality of health care Universal coverage medicine.symptom business medicine.drug |
| Zdroj: | Revista médica de Chile v.141 n.8 2013 SciELO Chile CONICYT Chile instacron:CONICYT |
| ISSN: | 0034-9887 |
| DOI: | 10.4067/s0034-98872013000800003 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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