Key result
Cuban AMI care evaluation reveals ~98% in-hospital antithrombotic compliance but poor pre-hospital reperfusion metrics.
Why the study?
Cardiovascular disease prevalence is increasing worldwide, and delivering high-quality care may be economically challenging in low- and middle-income scenarios, including Latin America.
Observational (n=660)
No
Quality of care evaluation for AMI in a Cuban hospital showed high adherence to admission antiplatelets but highlighted the need to improve pre-hospital quality markers like timely thrombolysis.
Retrospective ESC quality metrics evaluation in Latin America leaves open their real-world utility in LMICs; prospective studies needed before clinical adoption.
Background: Prevalence of cardiac conditions is increasing worldwide. Low and middle-income scenario (LMISs), especially in Latin America, don’t scape from this phenomenon. To give a high-quality cardiovascular disease care may be economic challenging for these countries, in every level of attention.Methods: Observational and retrospective study of quality of care evaluation using the European Society of Cardiology (ESC 2017) Quality of Care Working Group’s consensus on quality document, of admitted Acute Myocardial Infarction in a General Hospital in Sancti-Spiritus, Cuba.Results: Between 2017 and 2019, 660 patients with AMI were admitted, most of them (72%), presented with features of ST-elevation myocardial infarction. Thrombolytics were administered to 268 (72.4%) patients, 43 (16%) of them in less than 30 minutes after diagnosis. Double antiplatelet treatment was administered to 98.1% of patients at admission. However, only 163 (34.8%) were enrolled in secondary prevention programs. No information regarding Patient Experience, nor 30-day adjusted mortality, was collected. Secondary prevention was fulfilled around 90%Conclusion: Determination of the quality metrics brought some improvement for the perception of the actual quality of care in this low/middle income scenario. Pre-hospital quality markers need to be improved, before trying to introduce a higher level of treatment.
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Rodríguez-Ramos et al. (2020) conducted an observational in Acute Myocardial Infarction (n=660). Standard AMI care in a low/middle-income scenario was evaluated on Compliance with ESC quality indicators for AMI care. Evaluation of acute myocardial infarction care in a Cuban general hospital revealed high compliance with in-hospital antithrombotics (98.1%) but highlighted the need to improve pre-hospital reperfusion metrics.
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