A milestone in the treatment of myocardial infarction in Switzerland
The Swiss register on myocardial infarction “AMIS Plus” has reached 40,000 patients – a target turning it into the largest surveillance study in Switzerland and the second for this type of problem worldwide.
What is it, and what are its implications? Started in 1997 as a result of a joint project involving the Swiss societies of cardiology, internal medicine and intensive medicine, the AMIS Plus register, banking on the participation of 80 Swiss hospitals (among which Cardiocentro Ticino), collects and monitors the data of patients hospitalised and treated for acute myocardial infarction. Thanks to the extensive bulk of data gathered (approximately 200 items of information per patient), the project – mainly financed by private funds and the industry – made it possible to very accurately map out the behaviour of acute coronary diseases in Switzerland, as well as of their treatment regimens.
AMIS plus is currently considered – and rightfully so – a fundamental epidemiological tool by the national and international medical community, as well as one of great scientific value. The numerous studies conducted provide very useful information as to the treatment and management of the so-called acute coronary syndromes, which are currently the main cause of death in industrialised countries.
Let us take some examples. When analysing available data, clear treatment differences emerge within homogeneous population groups; in other words, patient age and gender orient physicians towards different therapeutic choices.
As for risk factors, apart from confirming the crucial prognostic role of diabetes, smoking and high cholesterol levels are proven to lower the age of infarction occurrence. In particular, smoking seems to advance the date of the first cardiac event by 9 years.
Moreover, the analysis of AMIS data also made it possible to monitor the impact and role of different treatments applied in the context of acute myocardial infarction: from drugs for myocardial protection, to antiaggregant-anticoagulant ones and primary coronary dilation in case of emergency. The latter, started in 2002, confirmed its standing as the elective treatment choice for all patients with acute coronary disease, and demonstrated its effectiveness over time in different sub-groups of patients, among which those with a particularly impaired initial clinical condition.
Finally, a recent study heightened the fundamental role of public information campaigns on the reduction of out-of-hospital times – the last barrier to bring down in the current therapy of acute myocardial infarction.
Thanks to the excellent work carried out by the numerous hospitals and co-ordination centres involved, the Swiss register on myocardial infarction has become an essential tool in the monitoring and treatment of patients suffering from acute myocardial infarction – a truly Swiss gem, to be defended with pride and, first and foremost, to be financially supported, so that it can continue grow in the forthcoming years, to the benefit of our population and the international medical community.
