The Urgency for Change in Cardiac Patient Management Acute Myocardial Infarction (AMI) remains one of the most critical conditions and the leading cause of death in Brazil. Although we have witnessed significant advances in revascularization procedures and hospital management, mortality rates and treatment challenges persist, especially in patients with associated comorbidities such as diabetes and hypertension.
The real challenge lies not only in the acute moment of the event but in ensuring effective, holistic, and continuous care after hospital discharge. It is here that the Nursing professional, with their comprehensive view and role as a case manager, becomes the key to transforming health outcomes in the country.
1. From Patient to System: Nursing Leadership in Integrated Care The theoretical framework of recent research points to the critical importance of adopting Integrated Care Models. The goal is to coordinate multiple professionals—physicians, nutritionists, physiotherapists—across the entire spectrum of the disease, from prevention to rehabilitation.
As a Specialist Nurse, I argue that Nursing is the pillar that sustains this integration. The holistic approach and emphasis on Patient-Centered Medicine require a professional who can:
- Coordinate the Team: Ensure that treatment plans are followed, guaranteeing efficiency and efficacy, which can even reduce hospital stays and associated costs.
- Promote Adherence: The nurse is the primary link of communication with the patient, translating complex medical plans into daily routines and improving treatment adherence and, consequently, clinical results.
- Manage Comorbidities: The risk of a negative prognosis increases drastically with the presence of conditions such as diabetes or chronic kidney disease. It is the Nursing professional who actively monitors and manages these comorbidities on a daily basis, controlling factors that influence the response to AMI treatment.
2. The Battle for Risk Factors: Educating for Prevention The article in question highlights that less than a third of post-myocardial infarction patients reach the ideal LDL cholesterol target. This reveals an alarming gap between clinical guidelines and actual practice.
Managing modifiable risk factors—such as smoking, hypertension, and obesity—is an essential component of the preventive approach. However, research shows that knowledge about AMI symptoms and risk factors is suboptimal, especially in populations with low education levels.
Our responsibility, as Nursing professionals, is to act actively on this front:
- Translating Science: We take the complexity of genetic and metabolic challenges (such as the relationship between non-alcoholic fatty liver disease and AMI, mentioned in recent studies) and transform it into clear, accessible lifestyle information.
- Focusing on the Foundation: We need targeted educational campaigns that address inequalities and reach at-risk populations, ensuring that the most critical risk factor is combated: the lack of information.
3. Overcoming Inequalities in Access to Care Health policies and resource allocation play a crucial role in the quality and access to care for AMI patients. The article reveals that the reduction in AMI mortality risk was less pronounced in regions like Northeast Brazil, due to socioeconomic inequalities and limited health access.
Our commitment is to equity:
- We must foster the implementation of models ensuring that treatment advances—such as optimal timing for revascularization and post-procedure renal function monitoring—reach all patients, regardless of their location or socioeconomic condition.
- The training of competent and skilled health professionals is essential to ensure the prevention and control of conditions that impact the population’s health.
Nursing does not just execute; it leads management, education, and the defense of equity. This is our contribution of great significance to the future of cardiovascular health in Brazil.
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