Impacto de la trombolisis y de la angioplastia primaria en pacientes con infarto agudo del miocardio tratados en centros hospitalarios terciarios

Background: Primary angioplasty is the most effective treatment of ST-segment elevation acute myocardial infarction (STEMI). However, its worldwide implementation is difficult to obtain. Therefore thrombolysis continues to be the treatment most commonly used. Aim: To evaluate inhospital and long ter...

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Autores principales:	Greig,Douglas, Corbalán,Ramón, Castro,Pablo, Campos,Pabla, Lamich,Rubén, Yovaniniz,Patricio
Lenguaje:	Spanish / Castilian
Publicado:	Sociedad Médica de Santiago 2008
Materias:	Angioplasty Myocardial infarction Thrombolytic therapy
Acceso en línea:	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872008000900002
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spelling	oai:scielo:S0034-988720080009000022008-11-12Impacto de la trombolisis y de la angioplastia primaria en pacientes con infarto agudo del miocardio tratados en centros hospitalarios terciariosGreig,DouglasCorbalán,RamónCastro,PabloCampos,PablaLamich,RubénYovaniniz,Patricio Angioplasty Myocardial infarction Thrombolytic therapy Background: Primary angioplasty is the most effective treatment of ST-segment elevation acute myocardial infarction (STEMI). However, its worldwide implementation is difficult to obtain. Therefore thrombolysis continues to be the treatment most commonly used. Aim: To evaluate inhospital and long term mortality of patients with STEMI treated with thrombolysis or angioplasty, in three hospitals participating in the Chilean National Registry of Acute MI (GEMIgroup). Material and tnethods: Registry of 1,634 consecutive patients with STEMI admited between 2002 and 2006. Risk was stratified using the Thrombolysis in Myocardial Infarction (TIMI) Risk Score. Hospital and log term mortalities were adjusted using logistic and Cox regression models. Results: Fifty nine percent of patients (967 patients aged 60±12 years, 77% males) were subjected to reperfusion therapies, 28% with primary angioplasty and 72% with thrombolysis. Hospital mortality rates among patients treated with thrombolysis and angioplasty were 10.9% and 5.6% (p =0.01), respectively The figures for long term mortality were 20.4% and 9.7%, respectively (p <0.01). Multivariate analysis confirmed the lower mortality among subjects treated with angioplasty, with an odds ratio (OR) in favor of angioplasty of 8.5 (95% confidence intervals (CI) 3-35) for in hospital mortality and of 4.7 (95% CI 2.6-8.3) for long term mortality. The higher benefits of angioplasty were observed in males, in the elderly and in patients with a TIMI score over >3. Conclusions: Hospital and long term mortality of patients with STEMI was lower among those treated with primary angioplasty. This treatment is most beneficial among males, in the elderly and in patients with a TIMI score >3 .info:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.136 n.9 20082008-09-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872008000900002es10.4067/S0034-98872008000900002
institution	Scielo Chile
collection	Scielo Chile
language	Spanish / Castilian
topic	Angioplasty Myocardial infarction Thrombolytic therapy
spellingShingle	Angioplasty Myocardial infarction Thrombolytic therapy Greig,Douglas Corbalán,Ramón Castro,Pablo Campos,Pabla Lamich,Rubén Yovaniniz,Patricio Impacto de la trombolisis y de la angioplastia primaria en pacientes con infarto agudo del miocardio tratados en centros hospitalarios terciarios
description	Background: Primary angioplasty is the most effective treatment of ST-segment elevation acute myocardial infarction (STEMI). However, its worldwide implementation is difficult to obtain. Therefore thrombolysis continues to be the treatment most commonly used. Aim: To evaluate inhospital and long term mortality of patients with STEMI treated with thrombolysis or angioplasty, in three hospitals participating in the Chilean National Registry of Acute MI (GEMIgroup). Material and tnethods: Registry of 1,634 consecutive patients with STEMI admited between 2002 and 2006. Risk was stratified using the Thrombolysis in Myocardial Infarction (TIMI) Risk Score. Hospital and log term mortalities were adjusted using logistic and Cox regression models. Results: Fifty nine percent of patients (967 patients aged 60±12 years, 77% males) were subjected to reperfusion therapies, 28% with primary angioplasty and 72% with thrombolysis. Hospital mortality rates among patients treated with thrombolysis and angioplasty were 10.9% and 5.6% (p =0.01), respectively The figures for long term mortality were 20.4% and 9.7%, respectively (p <0.01). Multivariate analysis confirmed the lower mortality among subjects treated with angioplasty, with an odds ratio (OR) in favor of angioplasty of 8.5 (95% confidence intervals (CI) 3-35) for in hospital mortality and of 4.7 (95% CI 2.6-8.3) for long term mortality. The higher benefits of angioplasty were observed in males, in the elderly and in patients with a TIMI score over >3. Conclusions: Hospital and long term mortality of patients with STEMI was lower among those treated with primary angioplasty. This treatment is most beneficial among males, in the elderly and in patients with a TIMI score >3 .
author	Greig,Douglas Corbalán,Ramón Castro,Pablo Campos,Pabla Lamich,Rubén Yovaniniz,Patricio
author_facet	Greig,Douglas Corbalán,Ramón Castro,Pablo Campos,Pabla Lamich,Rubén Yovaniniz,Patricio
author_sort	Greig,Douglas
title	Impacto de la trombolisis y de la angioplastia primaria en pacientes con infarto agudo del miocardio tratados en centros hospitalarios terciarios
title_short	Impacto de la trombolisis y de la angioplastia primaria en pacientes con infarto agudo del miocardio tratados en centros hospitalarios terciarios
title_full	Impacto de la trombolisis y de la angioplastia primaria en pacientes con infarto agudo del miocardio tratados en centros hospitalarios terciarios
title_fullStr	Impacto de la trombolisis y de la angioplastia primaria en pacientes con infarto agudo del miocardio tratados en centros hospitalarios terciarios
title_full_unstemmed	Impacto de la trombolisis y de la angioplastia primaria en pacientes con infarto agudo del miocardio tratados en centros hospitalarios terciarios
title_sort	impacto de la trombolisis y de la angioplastia primaria en pacientes con infarto agudo del miocardio tratados en centros hospitalarios terciarios
publisher	Sociedad Médica de Santiago
publishDate	2008
url	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872008000900002
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Impacto de la trombolisis y de la angioplastia primaria en pacientes con infarto agudo del miocardio tratados en centros hospitalarios terciarios

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