Sex Differences in Risk Factors, in Hospital Mortality and Treatment among the Patients with AMI in Durres Population.

The objectives for this paper are to investigate the differences in the risk factors, treatment and in hospital mortality between men and women among the patients with AMI in Durres population. Prospective Observational study was used. 259 patients consecutive with acute myocardial infarction (AMI) who presented in the Cardiology Department, Regional Hospital of Durres, Albania between January 2011 to October 2013 were included in the study. Demographic, diagnostic, therapeutic, and clinical data were collected from hospital medical records. Coronary risk factors and previous conditions were assessed by a specific questionnaire administered to patients. All variables were precisely defined and their collection was standardized. The CCU application of various diagnostic and therapeutic procedures was also recorded, including coronary angiography and reperfusion procedures. The results O

COST-EFFECTIVENESS OF BETA BLOCKERS AND THE SURVIVAL OF THE PATIENTS WITH HEART FAILURE IN THE CARDIOLOGY CENTER IN TIRANA

Objective: To evaluate the survival of the patients with heart failure in the Cardiology Center in Tirana, to evaluate the cost effectiveness of carvedilol versus metoprolol.Methods: 239 patients (pts) suffering chronic heart failure of different aetiologies, on traditional treatment for heart failure (angiotensin-converting enzyme inhibitors, diuretics, digoxin), with ejection fraction<50%, in NYHA class II-IV, were randomised to carvedilol 6.25-25 mg/day, or metoprolol 50-100 mg/day, or nebivolol 5 mg/day or treated only with the traditional treatment for they have contraindications regarding the use of β–blockers, followed for a two-year period.Results: There were included 239 patients of mild, moderate and severe heart failure, NYHA II-IV, with the fraction of ejection<50 hospitalized in the University clinic of cardiology of Tirana, followed for a two-year period; 83 patients (34.7%) were treated with Carvedilol; 70 patients (29.2%) were treated with metoprolol, 21 patients were treated with nebivolol (8.7%), and 65 patients (27.1%) were treated only with the traditional therapy (TTh).Conclusion: The use of carvedilol along with the traditional therapy of heart failure assures a higher survival rate and a lower hospitalization rate but an increase of cost of treatment of 216 €a year compared to metoprolol in addition with traditional therapy.Â

European Society of Cardiology: Cardiovascular Disease Statistics 2019

Aims The 2019 report from the European Society of Cardiology (ESC) Atlas provides a contemporary analysis of cardiovascular disease (CVD) statistics across 56 member countries, with particular emphasis on international inequalities in disease burden and healthcare delivery together with estimates of progress towards meeting 2025 World Health Organization (WHO) non-communicable disease targets. Methods and results In this report, contemporary CVD statistics are presented for member countries of the ESC. The statistics are drawn from the ESC Atlas which is a repository of CVD data from a variety of sources including the WHO, the Institute for Health Metrics and Evaluation, and the World Bank. The Atlas also includes novel ESC sponsored data on human and capital infrastructure and cardiovascular healthcare delivery obtained by annual survey of the national societies of ESC member countries. Across ESC member countries, the prevalence of obesity (body mass index ≥30 kg/m2) and diabetes has increased two- to three-fold during the last 30 years making the WHO 2025 target to halt rises in these risk factors unlikely to be achieved. More encouraging have been variable declines in hypertension, smoking, and alcohol consumption but on current trends only the reduction in smoking from 28% to 21% during the last 20 years appears sufficient for the WHO target to be achieved. The median age-standardized prevalence of major risk factors was higher in middle-income compared with high-income ESC member countries for hypertension {23.8% [interquartile range (IQR) 22.5–23.1%] vs. 15.7% (IQR 14.5–21.1%)}, diabetes [7.7% (IQR 7.1–10.1%) vs. 5.6% (IQR 4.8–7.0%)], and among males smoking [43.8% (IQR 37.4–48.0%) vs. 26.0% (IQR 20.9–31.7%)] although among females smoking was less common in middle-income countries [8.7% (IQR 3.0–10.8) vs. 16.7% (IQR 13.9–19.7%)]. There were associated inequalities in disease burden with disability-adjusted life years per 100 000 people due to CVD over three times as high in middle-income [7160 (IQR 5655–8115)] compared with high-income [2235 (IQR 1896–3602)] countries. Cardiovascular disease mortality was also higher in middle-income countries where it accounted for a greater proportion of potential years of life lost compared with high-income countries in both females (43% vs. 28%) and males (39% vs. 28%). Despite the inequalities in disease burden across ESC member countries, survey data from the National Cardiac Societies of the ESC showed that middle-income member countries remain severely under-resourced compared with high-income countries in terms of cardiological person-power and technological infrastructure. Under-resourcing in middle-income countries is associated with a severe procedural deficit compared with high-income countries in terms of coronary intervention, device implantation and cardiac surgical procedures. Conclusion A seemingly inexorable rise in the prevalence of obesity and diabetes currently provides the greatest challenge to achieving further reductions in CVD burden across ESC member countries. Additional challenges are provided by inequalities in disease burden that now require intensification of policy initiatives in order to reduce population risk and prioritize cardiovascular healthcare delivery, particularly in the middle-income countries of the ESC where need is greatest