Smoking more and more popular in heart attack patients in Argentina
Staff Writer |
Levels of smoking are rising in heart attack patients in Argentina, according to a study presented at the Argentine Congress of Cardiology (SAC 2016).
Article continues below
The findings coincide with a 100% increase in affordability in the last decade, which have made cigarettes among the cheapest in the world. Researchers also report improved treatment for heart attacks but no decrease in mortality.
The annual congress of the Argentine Society of Cardiology is being held in Buenos Aires from 13 to 15 October. Experts from the European Society of Cardiology (ESC) will present a special programme.
The study compared risk factors, treatment and outcomes of heart attack patients using the SCAR (2011) and ARGEN-IAM-ST (2015) surveys conducted by the Argentine Society of Cardiology.
The analysis included 676 patients with ST-segment elevation acute myocardial infarction (STEMI), of which 222 were from SCAR and 454 participated in ARGEN-IAM-ST. Only patients from centres participating in both registries were included.
There were no significant changes between the two surveys in age, gender, diabetes, high cholesterol or hypertension.
Patients who had a heart attack were 60 years old on average, around one-quarter were women, 20% had type 2 diabetes, around half had high cholesterol, and more than half had hypertension.
Smoking increased from 42% of heart attack patients in 2011 to 69% in 2015. "Sales of cigarettes in Argentina increased by almost 17% between 2011 and 2015," said Claudio Higa, leader of the SCAR survey and a cardiologist at Hospital Alemán in Buenos Aires.
"The rise of cigarette prices during the last decade was lower than the increase in incomes, making Argentina one of the countries with the cheapest cigarettes in the world," he continued. "Our study was observational so we cannot say this caused the increase in smoking but it likely contributed."
Treatment for STEMI improved between the two time periods. The rate of primary angioplasty, the recommended treatment, increased from 89% to 95%. The use of fibrinolytic agents, which are a second option when primary angioplasty is not possible, decreased from 11% to 4%.
Regarding the use of antithrombotic and antiplatelet drugs, the use of bivalirudin increased and there were decreases in the use of clopidogrel and glycoprotein IIb/IIIa inhibitors between the two time periods.
Looking at outcomes, the prevalence of cardiogenic shock was halved in 2015 compared to 2011, as was postinfarct angina.
But there were no differences in the rates of mortality and reinfarction during hospitalisation. Around 6-9% of patients died in hospital after their heart attack and 2% had another event.
Dr Higa said: "Treatment for heart attacks has improved in Argentina but unfortunately this has not translated into a reduction in deaths or repeat heart attacks.
"It could be that more time is needed for better therapy to show an impact, or that the study was too small to show any difference." ■