TY - JOUR
T1 - Tratamiento del infarto agudo de miocardio en el Perú y su relación con eventos adversos intrahospitalarios
T2 - resultados del segundo registro peruano de infarto de miocardio con elevación del segmento ST (PERSTEMI-II)
AU - Chacón-Diaz, Manuel
AU - Olivares, René Rodríguez
AU - Noé, David Miranda
AU - Custodio-Sánchez, Piero
AU - Cárdenas, Alexander Montesinos
AU - Galindo, Germán Yábar
AU - Rotta, Aida Rotta
AU - Bazán, Roger Isla
AU - de la Cuba, Paol Rojas
AU - Navarro, Nassip Llerena
AU - Rojas, Marcos López
AU - Cárdenas, Mauricio García
AU - Vásquez, Akram Hernández
N1 - Publisher Copyright:
© 2021, National Cardiovascular Institute - INCOR. All rights reserved.
PY - 2021/6/30
Y1 - 2021/6/30
N2 - Background. ST-segment elevation myocardial infarction (STEMI), is an important cause of morbidity and mortality worldwide, and myocardial reperfusion, when adequate, reduces the complications of this entity. The aim of the study was to describe the clinical and treatment characteristics of STEMI in Peru and the relationship of successful reperfusion with in-hospital adverse events. Materials and methods. Prospective, multicenter cohort of STEMI patients attended during 2020 in public hospitals in Peru. We evaluated the clinical, therapeutic characteristics and in-hospital adverse events, also the relationship between successful reperfusion and adverse events. Results. A total of 374 patients were included, 69.5% in Lima and Callao. Fibrinolysis was used in 37% of cases (pharmacoinvasive 26% and fibrinolysis alone 11%), primary angioplasty with < 12 hours of evolution in 20%, late angioplasty in 9% and 34% did not access adequate reperfusion therapies, mainly due to late presentation. Ischemia time was longer in patients with primary angioplasty compared to fibrinolysis (median 7.7 hours (RIQ 5-10) and 4 hours (RIQ 2.3-5.5) respectively). Mortality was 8.5%, the incidence of post-infarction heart failure was 27.8% and of cardiogenic shock 11.5%. Successful reperfusion was associated with lower cardiovascular mortality (RR:0.28; 95%CI: 0.12-0.66, p=0.003) and lower incidence of heart failure during hospitalization (RR: 0.61; 95%CI: 0.43-0.85, p=0.004). Conclusions. Fibrinolysis continues to be the most frequent reperfusion therapy in public hospitals in Peru. Shorter ischemia-to-reperfusion time was associated with reperfusion success, and in turn with fewer in-hospital adverse events.
AB - Background. ST-segment elevation myocardial infarction (STEMI), is an important cause of morbidity and mortality worldwide, and myocardial reperfusion, when adequate, reduces the complications of this entity. The aim of the study was to describe the clinical and treatment characteristics of STEMI in Peru and the relationship of successful reperfusion with in-hospital adverse events. Materials and methods. Prospective, multicenter cohort of STEMI patients attended during 2020 in public hospitals in Peru. We evaluated the clinical, therapeutic characteristics and in-hospital adverse events, also the relationship between successful reperfusion and adverse events. Results. A total of 374 patients were included, 69.5% in Lima and Callao. Fibrinolysis was used in 37% of cases (pharmacoinvasive 26% and fibrinolysis alone 11%), primary angioplasty with < 12 hours of evolution in 20%, late angioplasty in 9% and 34% did not access adequate reperfusion therapies, mainly due to late presentation. Ischemia time was longer in patients with primary angioplasty compared to fibrinolysis (median 7.7 hours (RIQ 5-10) and 4 hours (RIQ 2.3-5.5) respectively). Mortality was 8.5%, the incidence of post-infarction heart failure was 27.8% and of cardiogenic shock 11.5%. Successful reperfusion was associated with lower cardiovascular mortality (RR:0.28; 95%CI: 0.12-0.66, p=0.003) and lower incidence of heart failure during hospitalization (RR: 0.61; 95%CI: 0.43-0.85, p=0.004). Conclusions. Fibrinolysis continues to be the most frequent reperfusion therapy in public hospitals in Peru. Shorter ischemia-to-reperfusion time was associated with reperfusion success, and in turn with fewer in-hospital adverse events.
KW - Angioplasty
KW - Fibrinolysis
KW - Mortality
KW - Myocardial Infarction
KW - Peru
UR - http://www.scopus.com/inward/record.url?scp=85133136057&partnerID=8YFLogxK
U2 - 10.47487/apcyccv.v2i2.132
DO - 10.47487/apcyccv.v2i2.132
M3 - Artículo
AN - SCOPUS:85133136057
SN - 2708-7212
VL - 2
SP - 86
EP - 95
JO - Archivos Peruanos de Cardiologia y Cirugia Cardiovascular
JF - Archivos Peruanos de Cardiologia y Cirugia Cardiovascular
IS - 2
ER -