THERAPY OF ACUTE MYOCARDIAL-INFARCTION (1994-1996) IN NONACADEMIC SWISS HOSPITALS

The CHAMI study (Confederatio Helvetica Acute Myocardial Infarction) r ecorded the therapies administered for acute myocardial infarction in 520 consecutive patients between October 1994 and February 1996 at 10 nonacademic hospitals in Switzerland. The patients in this group consi sted of 363 men and 157 women with an average age of 63.2 years. The p rescribed medications administered from the day of hospital admission until the day of discharge were recorded. In the acute phase, the pati ents were given the following therapy: thrombolytic agents 40%, iv nit rates 65%, iv beta-blockers 22%, aspirin 95%, oral beta-blockers 36%, ACE inhibitors 14%. Impressive was the lower distribution of thromboly tic agents and beta-blockers among the older patients (age > 70) (thro mbolytic agents 52.1% vs 28.4%; oral beta-blockers 44.0% vs 29.1%) and in particular among women (thrombolytic agents 26.8% vs 46%; oral bet a-blockers 29.3% vs 39.7%) in men. Therapy at hospital discharge consi sted, inter alia, of aspirin (73%), beta-blockers (54%), ACE inhibitor s (3%), and lipid lowering agents (10%). The hospital mortality was 12 .6%. The CHAMI study provided the participating hospitals with a quali ty control comparison with other participating centers and impressivel y demonstrated with the example of the lipid lowering agents, that the significance of secondary prophylaxis is assigned too little importan ce in contrast to acute therapy.