| Titre : | 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 ? (1998) |
| Auteurs : | M. DA GRACA BOURQUIN ; F. PACCAUD ; F. PERRET ; M. RICKENBACH ; V. WIETLISBACH ; Institute for Social and Preventive Medicine. University of Lausanne. CHE |
| Type de document : | Article |
| Dans : | Journal of clinical epidemiology (vol. 51, n° 9, 1998) |
| Pagination : | 722-732 |
| Langues: | Anglais |
| Mots-clés : | Infarctus ; Myocarde ; Evolution ; Epidémiologie ; Thérapeutique médicamenteuse ; Thérapeutique ; Homme ; Suisse ; Europe ; Appareil circulatoire [pathologie] ; Cardiopathie coronaire ; Myocarde [pathologie] |
| Résumé : | [BDSP. Notice produite par INIST R0xWh060. Diffusion soumise à autorisation]. 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. |
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