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An Audit of Cardiac Mortality Due to Acute Myocardial Infarction at a Tertiary Institution in the Southwestern Region of Trinidad and Tobago

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Objective: This study aims to identify the profile of patients who died from acute myocardial infarction (AMI) during hospital admission in southwest Trinidad. 

Methods: This retrospective descriptive study was done using the death register of the San Fernando General Hospital (SFGH) during the period 2011 and 2012. Confirmed cases of AMI were selected based on the American College of Cardiology (ACC)/American Heart Association (AHA) guidelines 2011 or 2013. Relevant information on patient’s profile, risks for ischaemic heart disease (IHD), clinical presentation and treatment were analysed using SPSS version 19 software.

Results: Males accounted for 56.3% and females 43.8% of AMI deaths. East Indians were predominantly affected with an East Indian:African:Mixed ratio of 5:1:2. The mean age was 68.6 years and 72.8 years for males and females, respectively. The combination of diabetes mellitus and hypertension was responsible for most (52.5%) AMI deaths. Patients who were not diabetic, hypertensive, smoking nor hypercholesterolaemic accounted for six (7.5%) of the total deaths (4 = East Indians, 2 = Mixed). One death occurred in the emergency department while the rest occurred in the ward; 44% of deaths occurred within 48 hours. Non-ST segment elevation myocardial infarction (NSTEMI) accounted for 70.0% and STEMI for 30.0% of AMI deaths. Five (20.8%) of the 24 STEMI patients received thrombolytic treatment on arrival to casualty department.  

Conclusion: Deaths occurred predominantly among males of East Indian descent at a mean age of 70 years.  The East Indian:African mortality ratio was 5:1. Patients suffered mainly from diabetes mellitus, hypertension or a combination of both.  


June 19, 2014
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