Descripción demográfica y desenlaces de una red metropolitana de atención para el infarto agudo de miocardio

Autor: Rodrigo Gopar-Nieto, Diego Araiza-Garaygordobil, Grecia I. Raymundo-Martínez, Pablo Martínez-Amezcua, Alejandro Cabello-López, Daniel Manzur-Sandoval, Nancy L. Chávez-Gómez, Arnoldo E. Loáisiga-Sáenz, Luis A. Baeza-Herrera, Carlos A. Dattoli-García, Leticia A. Gallardo-Grajeda, Cynthia N. Jackson-Pedroza, Brandon Salas-Teles, Alexandra Arias-Mendoza
Jazyk: English<br />Spanish; Castilian
Rok vydání: 2021
Předmět:
Zdroj: Archivos de Cardiología de México, Vol 91, Iss 2 (2021)
Druh dokumentu: article
ISSN: 1405-9940
1665-1731
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: Directory of Open Access Journals
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