Demographic description and outcomes of a metropolitan network for myocardial infarction treatment.

Autor:	Gopar-Nieto R; Coronary Unit, Instituto Nacional de Cardiología 'Ignacio Chávez', Mexico City, Mexico., Araiza-Garaygordobil D; Coronary Unit, Instituto Nacional de Cardiología 'Ignacio Chávez', Mexico City, Mexico., Raymundo-Martínez GI; Coronary Unit, Instituto Nacional de Cardiología 'Ignacio Chávez', Mexico City, Mexico., Martínez-Amezcua P; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA., Cabello-López A; Unidad de Investigación de Salud en el Trabajo, Centro Médico Nacional Siglo XXI, Mexico City, Mexico., Manzur-Sandoval D; Coronary Unit, Instituto Nacional de Cardiología 'Ignacio Chávez', Mexico City, Mexico., Chávez-Gómez NL; Coronary Unit, Instituto Nacional de Cardiología 'Ignacio Chávez', Mexico City, Mexico., Loáisiga-Sáenz AE; Coronary Unit, Instituto Nacional de Cardiología 'Ignacio Chávez', Mexico City, Mexico., Baeza-Herrera LA; Coronary Unit, Instituto Nacional de Cardiología 'Ignacio Chávez', Mexico City, Mexico., Dattoli-García CA; Coronary Unit, Instituto Nacional de Cardiología 'Ignacio Chávez', Mexico City, Mexico., Gallardo-Grajeda LA; Coronary Unit, Instituto Nacional de Cardiología 'Ignacio Chávez', Mexico City, Mexico., Jackson-Pedroza CN; Coronary Unit, Instituto Nacional de Cardiología 'Ignacio Chávez', Mexico City, Mexico., Salas-Teles B; Coronary Unit, Instituto Nacional de Cardiología 'Ignacio Chávez', Mexico City, Mexico., Arias-Mendoza A; Coronary Unit, Instituto Nacional de Cardiología 'Ignacio Chávez', Mexico City, Mexico.
Jazyk:	angličtina
Zdroj:	Archivos de cardiologia de Mexico [Arch Cardiol Mex] 2021 Jan 20; Vol. 91 (2), pp. 167-177. Date of Electronic Publication: 2021 Jan 20.
DOI:	10.24875/ACM.20000133
Abstrakt:	Objective: The objective of the study was to describe the myocardial infarction treatment network and compare in-hospital mortality in patients undergoing either primary angioplasty or pharmacoinvasive strategy in Mexico City and a broad metropolitan area. Methods: Cohort study including patients with ST-elevation myocardial infarction. We recorded demographic and clinical data, laboratory tests and in-hospital mortality in patients that underwent primary angioplasty and pharmacoinvasive strategy. Kaplan-Meier analysis was used to assess mortality and Cox-regression assessed mortality risk factors. Results: Three hundred forty patients from a network of 60 hospitals and 9 states were analyzed. Of the total population, 166 were treated with pharmacoinvasive strategy and 174 with primary angioplasty. Door to thrombolytic time was 54 min and door to wire crossing time was 72.5 min; no differences in total ischemia time were demonstrated. No differences for in-hospital mortality (6.3% vs. 5.4%, p = 0.49) were found when comparing pharmacoinvasive and primary angioplasty groups. The main predictors for in-hospital mortality were: glucose > 180 mg/dl (HR 3.73), total ischemia time > 420 min (HR 3.18), heart rate > 90 bpm (HR 5.46), Killip and Kimball > II (HR 11.03), and left ventricle ejection fraction < 40% (HR 3.21). Conclusions: This myocardial infarction network covers a large area and constitutes one of the biggest in the world. There were no differences regarding in-hospital mortality between pharmacoinvasive strategy and primary angioplasty. Pharmacoinvasive strategy is an effective and safe option for prompt reperfusion in Mexico.
Databáze:	MEDLINE
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