Characteristics, management and prognosis of acute myocardial infarction in the Valencia autonomous community in 1995: The PRIMVAC register results (Proyecto de Registro de Infarto agudo de Miocardio de Valencia, Alicante y Castellon)

Background and objectives. Regional registers of patients with acute myocar dial infarction are scarce in Spain. The PRIMVAC register (Proyecto de Regi stro de Infarto agudo de Miocardio de Valencia, Alicante y Castellon) was i nitiated to obtain updated information on the management of these patients in the Valencia Autonomous Community. Data of the first twelve months of th e register are presented. Methods. The 17 participating hospitals cover 2,833,938 inhabitants. Demogr aphic, clinical, procedural and outcome data as well as predictive variable s of mortality were analysed in the patients with acute myocardial infarcti on during their stay in the coronary care units from 1 December 1994 to 30 November 1995. Results. During 12 months, 2,377 patients were included. Mean age was 65.3 years (SD 11.9) and 23.2% were female. Left ventricular failure was present in 39.8%. Thrombolytic therapy was applied in 42.1% with a median time del ay of 195 min from chest pain onset. This time was longer in the women (250 min) and in the elderly (210 min). The in-coronary-care-unit-mortality rat e was 13.9%. Age, female gender, diabetes, previous myocardial infarction, Q wave and right ventricular infarction independently predicted increased e arly mortality Conclusion. Present data show the feasibility of an acute myocardial infarc tion register in the Valencia Autonomous Community. Although an acceptable level of thrombolysis has been reached, the mortality rate is still high. T he long delay in initiating thrombolysis, particularly in female and elderl y patients is remarkable.