ArticleBMC health services research2009
Quality of care of patients with acute myocardial infarction in Bulgaria: a cross-sectional study.
Article in BMC health services research, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 19 citations in OpenAlex.
- Assessment of Cardiovascular Risk Categories and Achievement of Therapeutic Targets in European Patients with Type 2 Diabetes.Journal of clinical medicine · 2024Article
- Clinical determinants of ischemic heart disease in Eastern Europe.The Lancet regional health. Europe · 2023Review
- Factors Responsible for Prehospital Delay in Patients with Acute Coronary Syndrome in Bangladesh.Medicina (Kaunas, Lithuania) · 2022Article
- Overall satisfaction of health care users with the quality of and access to health care services: a cross-sectional study in six Central and Eastern European countries.BMC health services research · 2016Article
- Socioeconomic status, functional recovery, and long-term mortality among patients surviving acute myocardial infarction.PloS one · 2014Article
- CVD and obesity in transitional Syria: a perspective from the Middle East.Vascular health and risk management · 2012Review
- Growing epidemic of coronary heart disease in low- and middle-income countries.Current problems in cardiology · 2010Review
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Authors and funding
3 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCardiovascular diseases are the major cause of death in Bulgaria. Because of notable differences in mortality rates between Bulgaria and other European countries, we presume a tangible difference in the management of acute myocardial infarction (AMI) and an underutilization of evidence-based treatments. In order to determine the quality of care of patients with AMI in Bulgaria, we analyzed the appropriateness of current treatments and their relation to patient characteristics.
methodsWe performed a descriptive cross-sectional study, using retrospectively collected data from medical charts. We included all patients with AMI, residing and admitted to hospitals in the region of Stara Zagora, Bulgaria, between September 1st and December 31st, 2004. Socioeconomic status was surveyed within the framework of a structured patient interview. We used chi-square tests with Fisher's exact probabilities to analyze the relationship between prehospital time delay age, sex, and socio-economic status of the patients and Student's independent samples t-tests to check hypotheses about means.
resultsFrom 134 patients with AMI (mean age 64.6, SD 13.2, 66% male), 7% presented to a hospital within 59 minutes, and 44% within 4 hours of symptoms onset. The use of Heparin was 98%. In the first 24 hours, ASS was administrated in 82% and beta-Blockers in 73% of the cases. At discharge Aspirin, beta-Blockers, Angiotensin Converting Enzyme Inhibitors or AR-Blockers and Statins were used in 85%, 79%, 66%, and 43% of cases respectively. Intravenous fibrinolysis was applied in 32% of the eligible patients with ST-segment elevation. Percutaneous coronary interventions were applied in four patients within the first month after AMI. Hospital location in relation to a patient's place of residence and manner of transportation to hospital did not influence the time delay between the onset of symptoms to the start of hospital treatment. In the study region, a relation between time delay and both age and education level was observed.
conclusionThe actual quality of care of patients with AMI in Bulgaria lies far from the evidence-based recommendations. Additional research and improvements in health services are needed to reduce the burden of cardiovascular disease in Bulgaria.
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