Key result
Quality of care for STEMI in Cuba was suboptimal, with thrombolytic therapy administered to 51% of patients, coronary intervention to 19.3%, and an overall mortality rate of 8.9%.
Why the study?
In Cuba, there is neither a registry of STEMI nor are analyses of performance measures widely reported.
What is the quality of care for patients with STEMI in Cuba before the COVID-19 pandemic?
Systematic Review (n=7,823)
What is the quality of care for patients with STEMI in Cuba before the COVID-19 pandemic?
Quality of care for STEMI patients in Cuba before the COVID-19 pandemic was suboptimal, characterized by low rates of thrombolytic administration and insufficient adherence to guideline-directed pharmacological treatments.
Limited Cuban STEMI data preclude care quality assessment; leaves open whether a national registry would improve outcomes.
BACKGROUND: In Cuba, there is neither a registry of ST Elevation Myocardial Infarction (STEMI), nor are analysis of performance measures widely reported. OBJECTIVE: A review of Cuban studies of patients with STEMI was carried out to describe quality of medical care. METHODS: Cochrane Library, EMBASE, PubMed, Scopus and SciELO, as well as archives of national journals, were all searched for articles on STEMI in Cuba, from 2000 to March 2020. They were included if they reported number or percentage of application of reperfusion therapy; administration of aspirin, enalapril-captopril (ACEI) or beta-blockers; status of patients at discharge; and patient or system delay times. Finally, 17 reports with 7823 patients were included. RESULTS: Thrombolytic therapy was administered to 3991 patients (51%), and 695 patients (8.9%) died. Only four studies, with 880 patients, presented data about prescription of ACEI, aspirin, and beta-blockers, which were administered to 381 (45.3%), 824 (93.6%), 464 (52.7%) patients, respectively. Coronary intervention was reported in 5 studies with 3422 patients, being performed in 661 (19.3%). Conclusions: Quality of care of patients with STEMI seems to be poorer than reported in similar scenarios. Thrombolytic administration is still low, although mortality decreases in this period. Other pharmacological treatments were insufficiently fulfilled.
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Remedios-Carbonell et al. (2023) conducted a systematic review in ST-segment Elevation Myocardial Infarction (STEMI) (n=7,823). STEMI medical care and reperfusion therapy was evaluated on Application of reperfusion therapy and mortality. Quality of care for STEMI in Cuba was suboptimal, with thrombolytic therapy administered to 51% of patients, coronary intervention to 19.3%, and an overall mortality rate of 8.9%.
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