Manuel Alberto Chacón-Diaz1, Jorge Alonso Barrios-Escalante2, Daniel Espinoza-Alva2. 1. Adult Clinic Cardiology Department, Instituto Nacional Cardiovascular Carlos Alberto Peschiera Carrillo - INCOR, Lima, Peru. Electronic address: mchacon@auna.pe. 2. Adult Clinic Cardiology Department, Instituto Nacional Cardiovascular Carlos Alberto Peschiera Carrillo - INCOR, Lima, Peru.
Abstract
OBJECTIVE: To assess the features of asymptomatic patients with acute ST segment elevation myocardial infarction who presents to the emergency with more than 12h of evolution, and if there is a benefit of an invasive versus medical therapy. METHODS: Retrospective, cohort study from January 2012 to December 2014, we compare the outcomes at 6 and 12 months of follow up of the invasive group versus the conservative group. RESULTS: There were no differences in outcomes at 12 months between an invasive versus a conventional strategy; but, looking at the reperfusion state, we found more risk of death and heart failure at 12 months in the no-reperfused group versus the reperfused group (40% versus 0%, OR: 2, CI: 1.2-3.1, p=0.028 for mortality and 53% versus 0%, OR: 2.2, CI: 1.3-3.98, p=0.007 for heart failure). CONCLUSIONS: In patients with ST elevation acute myocardial infarction with more than 12h of evolution, the invasive strategy with optimal reperfusion is better than the conservative management or no reperfusion in terms of less mortality and heart failure at 12 months of follow up.
OBJECTIVE: To assess the features of asymptomatic patients with acute ST segment elevation myocardial infarction who presents to the emergency with more than 12h of evolution, and if there is a benefit of an invasive versus medical therapy. METHODS: Retrospective, cohort study from January 2012 to December 2014, we compare the outcomes at 6 and 12 months of follow up of the invasive group versus the conservative group. RESULTS: There were no differences in outcomes at 12 months between an invasive versus a conventional strategy; but, looking at the reperfusion state, we found more risk of death and heart failure at 12 months in the no-reperfused group versus the reperfused group (40% versus 0%, OR: 2, CI: 1.2-3.1, p=0.028 for mortality and 53% versus 0%, OR: 2.2, CI: 1.3-3.98, p=0.007 for heart failure). CONCLUSIONS: In patients with ST elevation acute myocardial infarction with more than 12h of evolution, the invasive strategy with optimal reperfusion is better than the conservative management or no reperfusion in terms of less mortality and heart failure at 12 months of follow up.
Authors: Rodrigo Vargas-Fernández; Manuel Chacón-Diaz; Gianfranco W Basualdo-Meléndez; Francisco A Barón-Lozada; Fabriccio J Visconti-Lopez; Daniel Comandé; Akram Hernández-Vásquez Journal: BMJ Open Date: 2022-09-14 Impact factor: 3.006