Skip to main content
NCBI home page
British Heart Journal logoLink to British Heart Journal
. 1995 Jun;73(6):576–580. doi: 10.1136/hrt.73.6.576

National perspective of acute coronary care in the Republic of Ireland.

P A O'Callaghan 1, D M Comerford 1, I M Graham 1, I Higgins 1, L E Daly 1, K Robinson 1, M McLoughlin 1, D Kilcoyne 1, N Hickey 1, M J Walsh 1
PMCID: PMC483923  PMID: 7626360

Abstract

OBJECTIVE--To assess the use of acute coronary care facilities in the Republic of Ireland with regard to case mix, patient characteristics, mortality and factors associated with mortality, time intervals to admission, utilisation of thrombolysis, and risk factor profiles. DESIGN--A 1 week prospective census of all hospitals admitting acute coronary cases. These comprised 23 coronary care units (CCU) and 17 combined coronary care/intensive care units (CCU/ICU). Data were collected by standardised methods on each new patient "upon whom a cardiac monitor was placed". RESULTS--Acute coronary heart disease was confirmed in 185 (44.9%) of 412 patients. Of these 109 (26.4%) had a confirmed myocardial infarction and 76 (18.4%) unstable angina. Women were significantly older than men in all groups. Of those with proven acute coronary heart disease, 42.6% were current smokers, 23.1% were aware of having a raised cholesterol concentration, and 42.3% gave a history of prior hypertension. Only 44% were transported by ambulance. Median delay time from the onset of symptoms to admission was 6 h in Dublin and 4 h elsewhere. 34.9% of patients with a confirmed myocardial infarction received thrombolysis. Mortality of patients with myocardial infarction CCU/ICU at 7 days was 10.9 %. CONCLUSIONS--There is potential for considerable improvement in the management of coronary heart disease in the Republic of Ireland through a reduction in delay times to admission to hospital, increased use of thrombolytic treatment, and intensification of advice on primary and secondary risk factors.

Full text

PDF
576

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. DAY H. W. Preliminary studies of an acute coronary care area. J Lancet. 1963 Feb;83:53–55. [PubMed] [Google Scholar]
  2. DeWood M. A., Spores J., Notske R., Mouser L. T., Burroughs R., Golden M. S., Lang H. T. Prevalence of total coronary occlusion during the early hours of transmural myocardial infarction. N Engl J Med. 1980 Oct 16;303(16):897–902. doi: 10.1056/NEJM198010163031601. [DOI] [PubMed] [Google Scholar]
  3. Gibbons R. J., Clements I. P., Zinsmeister A. R., Brown M. L. Exercise response of the systolic pressure to end-systolic volume ratio in patients with coronary artery disease. J Am Coll Cardiol. 1987 Jul;10(1):33–39. doi: 10.1016/s0735-1097(87)80156-0. [DOI] [PubMed] [Google Scholar]
  4. KOUWENHOVEN W. B., JUDE J. R., KNICKERBOCKER G. G. Closed-chest cardiac massage. JAMA. 1960 Jul 9;173:1064–1067. doi: 10.1001/jama.1960.03020280004002. [DOI] [PubMed] [Google Scholar]
  5. Kennedy J. W., Ritchie J. L., Davis K. B., Stadius M. L., Maynard C., Fritz J. K. The western Washington randomized trial of intracoronary streptokinase in acute myocardial infarction. A 12-month follow-up report. N Engl J Med. 1985 Apr 25;312(17):1073–1078. doi: 10.1056/NEJM198504253121701. [DOI] [PubMed] [Google Scholar]
  6. LOWN B., AMARASINGHAM R., NEUMAN J. New method for terminating cardiac arrhythmias. Use of synchronized capacitor discharge. JAMA. 1962 Nov 3;182:548–555. [PubMed] [Google Scholar]
  7. McGee H. M., O'Callaghan D., MacGowan G. A., Horgan H. J. Factors associated with delay to treatment for acute myocardial infarction in Ireland. Ir Med J. 1994 Nov-Dec;87(6):187–168. [PubMed] [Google Scholar]
  8. McNeilly R. H., Pemberton J. Duration of last attack in 998 fatal cases of coronary artery disease and its relation to possible cardiac resuscitation. Br Med J. 1968 Jul 20;3(5611):139–142. doi: 10.1136/bmj.3.5611.139. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Mulcahy R., Daly L., Graham I., Hickey N. Level of education, coronary risk factors and cardiovascular disease. Ir Med J. 1984 Oct;77(10):316–318. [PubMed] [Google Scholar]
  10. Muller D. W., Topol E. J. Selection of patients with acute myocardial infarction for thrombolytic therapy. Ann Intern Med. 1990 Dec 15;113(12):949–960. doi: 10.7326/0003-4819-113-12-949. [DOI] [PubMed] [Google Scholar]
  11. Pell A. C., Miller H. C. Delays in admission of patients with acute myocardial infarction to coronary care: implications for thrombolysis. Health Bull (Edinb) 1990 Sep;48(5):225–231. [PubMed] [Google Scholar]
  12. Robinson K., Conroy R. M., Mulcahy R., Hickey N. Risk factors and in-hospital course of first episode of myocardial infarction or acute coronary insufficiency in women. J Am Coll Cardiol. 1988 May;11(5):932–936. doi: 10.1016/s0735-1097(98)90048-1. [DOI] [PubMed] [Google Scholar]
  13. Stevenson R., Ranjadayalan K., Wilkinson P., Roberts R., Timmis A. D. Short and long term prognosis of acute myocardial infarction since introduction of thrombolysis. BMJ. 1993 Aug 7;307(6900):349–353. doi: 10.1136/bmj.307.6900.349. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Walsh M. J. The coronary care unit: a reappraisal. Ir Med J. 1987 Dec;80(12):394–396. [PubMed] [Google Scholar]
  15. Weaver W. D., Litwin P. E., Martin J. S., Kudenchuk P. J., Maynard C., Eisenberg M. S., Ho M. T., Cobb L. A., Kennedy J. W., Wirkus M. S. Effect of age on use of thrombolytic therapy and mortality in acute myocardial infarction. The MITI Project Group. J Am Coll Cardiol. 1991 Sep;18(3):657–662. doi: 10.1016/0735-1097(91)90784-7. [DOI] [PubMed] [Google Scholar]

Articles from British Heart Journal are provided here courtesy of BMJ Publishing Group

RESOURCES