Descripción demográfica y desenlaces de una red metropolitana de atención para el infarto agudo de miocardio
| Autor: | Luis A. Baeza-Herrera, Nancy Libertad Chávez-Gómez, Daniel Manzur-Sandoval, Arnoldo E. Loáisiga-Sáenz, Rodrigo Gopar-Nieto, Alejandro Cabello-López, Carlos A. Dattoli-García, Pablo Martinez-Amezcua, Brandon Salas-Teles, Grecia I M Raymundo-Martínez, Alexandra Arias-Mendoza, Diego Araiza-Garaygordobil, Leticia A. Gallardo-Grajeda, Cynthia Jackson-Pedroza |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Ejection fraction business.industry Myocardial infarction. Thrombolytic therapy. Angioplasty. Mortality medicine.disease Metropolitan area medicine.anatomical_structure Ventricle RC666-701 Internal medicine Heart rate medicine Cardiology Diseases of the circulatory (Cardiovascular) system In patient Myocardial infarction Cardiology and Cardiovascular Medicine business Total ischemia Cohort study |
| Zdroj: | Archivos de Cardiología de México, Vol 91, Iss 2 (2021) |
| ISSN: | 1405-9940 |
| DOI: | 10.24875/acm.20000133 |
| Popis: | 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: | OpenAIRE |
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