Reducing mortality in myocardial infarction: Experience in Cuba shows optimising thrombolysis may reduce death rates in poor countries

doi:10.1136/bmj.330.7502.1271-b

BMJ 2005;330:1271-1272 (28 May), doi:10.1136/bmj.330.7502.1271-b

Letter

Reducing mortality in myocardial infarction

Experience in Cuba shows optimising thrombolysis may reduce death rates in poor countries

The first 150 words of the full text of this article appear below.

Editor—The epidemic of cardiovascular disease has peakedin Cuba and accounts for 40% of deaths.¹ The age adjusted mortalityin 2003 was 41% lower than the comparable rate recorded in 1970.The reduction in mortality from coronary heart disease, whichaccounts for nearly 74% of all cardiovascular deaths, drovethe overall decline in cardiovascular mortality.¹ Data fromCuba are highly accurate since registration has been consistentlyhigh over this 30 year period and deaths attributed to ill definedcauses have remained very low (0.7%). Nearly all deaths arecertified by a doctor.

In Cienfuegos province, Cuba's showcase for prevention and controlof cardiovascular disease, the number of admissions for acutemyocardial infarction doubled in 1990-2003. Over the same period,case fatality rates declined by 40-50%, which implies that lesssevere cases are being admitted, although the quality of careis also improving. This latter possibility is supported by thefact . . . [Full text of this article]

Pedro O Ordúñez-García, general director¹, Marcos Iraola-Ferrer, doctor¹, Yanelis La Rosa-Linares, doctor¹

¹ Hospital Gustavo Aldereguía, Cienfuegos 55 100, Cuba porduñez@gal.sld.cu