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

Type Journal Article - WIMJ Open
Title An Audit of Cardiac Mortality Due to Acute Myocardial Infarction at a Tertiary Institution in the Southwestern Region of Trinidad and Tobago
Author(s)
Volume 2
Issue 2
Publication (Day/Month/Year) 2015
Page numbers 60-65
URL http://www.mona.uwi.edu/wimjopen/sites/default/files/wimjopen/article_pdfs/Bahall and​Seemungal--Acute Myocardial Infarction in Trinidad.pdf
Abstract
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 the 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.

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