BARCELONA, Spain -- A new analysis of data gathered from an international drug study shows that patients in Latin America were treated with a more conservative approach and were nearly twice as likely to die within a month of being hospitalized for heart problems than were patients treated in North America.

The study also found that the Latin American patients received far fewer diagnostic procedures and only half as many angioplasties and cardiac bypass surgeries as did similar patients treated in the United States and Canada.

A team of international investigators, led by the Duke University Medical Center in Durham, N.C., prepared the findings for presentation at the annual meeting of the European Society of Cardiology.

Their analysis was done using information gathered on 585 patients treated at 72 hospitals in eight Latin American countries and 4,358 patients treated at 307 hospitals in the United States and Canada during a clinical trial called PURSUIT ("Platelet glycoprotein Iib/IIIa in Unstable angina: Receptor Suppression Using Integrilin Therapy trial"). The study tested the use of Eptifibatide, a class of "super aspirin" drugs that help stop blood clots from forming. Patients were enrolled if they had chest pain or tests that indicated they were suffering from a heart attack or would probably soon have one.

"From what our study tells us, hospital physicians in Latin America take a much more conservative approach to treating patients with a heart attack than do doctors in North America, and this could be one of the factors associated with poorer patient survival," said the study's lead author, Dr. Mauricio Cohen, a cardiology fellow at the Duke Clinical Research Institute (DCRI).

He said that a "conservative" approach may reflect the way Latin American physicians are trained to treat heart patients. It is also possible that factors, not captured in the PURSUIT trial's data, such as less sophisticated hospital facilities and staffi
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Contact: Richard Merritt
merri006@mc.duke.edu
919-684-4148
Duke University Medical Center
30-Aug-1999