Acute myocardial infarction risk factors, characteristics and outcome : a retrospective analysis of experience in the public sector

Abstract EN

Objective: To describe the demographic characteristics and determine the frequency of the various risk factors and types of myocardial infarction among patients presenting with acute myocardial infarction and the type of treatment, the mean door to treatment time and to assess the differences between males and females at Queen Alia Heart Institute/ King Hussein Medical Center, and Al-Basheer Hospital.

Methods: This was a retrospective analysis among patients presented with acute myocardial infarction and were treated at the two main public hospitals in Amman-Jordan (Queen Alia Heart Institute/ King Hussein Medical Center, and Al-Basheer Hospital) between November 2002 and July 2005.

Demographic characteristics, risk factors for coronary artery disease, type of myocardial infarction, door to needle time, hospital stay, various complications and in-hospital mortality were collected through a specially designed record abstract form.

Simple descriptive statistical analysis using mean percentage was used.

Chi-square test was used to determine statistically significant difference including demographic characteristics and risk factors among the study group was used.

P-value < 0.05 was considered significant.

Results: The study group was 730 patients.

Twenty one percent were females.

The mean age and standard deviation of the study group was 57.4 ± 11 years.

The mean age and standard deviation for females was 61.7 ± 9.6 years and for males 56.3 ± 11.1 years (P<0.001).

Sixty two percent were smokers.

Only 18% of females were smokers compared to 73.8% of males.

The frequency of diabetes and hypertension were 40.1% and 40.2% respectively.

Family history of coronary artery disease was present in 24%, 25% in males compared to 22% in females (P> 0.01).

Hypercholesterolemia was present in 18%; 22.6% in females compared to 17.4% in males (P> 0.01).

The mean door to treatment time was 42 ± 58 minutes; 44 ± 48.6 minutes in females compared to 38.5 ± 40 minutes in males.

Complications encountered during the index study period occurred in 24%; 16% in females compared to 25% in males (P<0.01).

Complications ranged from bleeding 3%, hypotension 7%, ventricular arrhythmia 6%, conduction defects in 1.6% and re-infarction in 1.6%.

The mean hospital stay was 5.2 ± 3.0 days.

Females had a mean stay of 5.6 ± 3.7 days compared to 5.1 ± 2.3 days in males.

In-hospital mortality was 4.3% ± 3.7 in females and 4.5% in males.

Conclusion: Our data showed high frequency of smoking, diabetes, hypertension with the later two being more frequent in females, who tended to be older.

Males had significantly higher in-hospital complications than females.

The main delay to reperfusion in Jordan is to seeking medical advice, with longer delay noted in females.