Carlos Martinez-Sanchez1, Gabriela Borrayo2, Jorge Carrillo3, Ursulo Juarez4, Juan Quintanilla5, Carlos Jerjes-Sanchez6. 1. Executive Committee of RENASICA III, Mexico; Emergency Department and Coronary Critical Care, Instituto Nacional de Cardiología "Ignacio Chavez", Mexico. 2. Executive Committee of RENASICA III, Mexico; Hospital de Cardiologia, Centro Medico Nacional Siglo XXI, Mexico. 3. Executive Committee of RENASICA III, Mexico; Cardiology Department in Hospital Central Dr. Ignacio Morones Prieto, San Luis Potosi, Mexico. 4. Executive Committee of RENASICA III, Mexico; Instituto Nacional de Cardiologia Ignacio Chavez, Mexico. 5. Executive Committee of RENASICA III, Mexico; Hemodynamic Laboratory, Hospital San Jose and Instituto de Cardiologia y Medicina Vascular, TEC Salud, Mexico. 6. Executive Committee of RENASICA III, Mexico; National Coordinator, Mexico; Instituto de Cardiologia y Medicina Vascular, TEC Salud, Mexico; Translational Research Center, Escuela de Medicina, Tecnologico de Monterrey, Mexico. Electronic address: jerjes@prodigy.net.mx.
Abstract
OBJECTIVE: To describe current management and clinical outcomes in patients hospitalized with an acute coronary syndrome (ACS) in Mexico. METHODS: RENASICA III was a prospective multicenter registry of consecutive patients hospitalized with an ACS. Patients had objective evidence of ischemic heart disease; those with type II infarction or secondary ischemic were excluded. Study design conformed to current quality recommendations. RESULTS: A total of 123 investigators at 29 tertiary and 44 community hospitals enrolled 8296 patients with an ACS (4038 with non-ST-elevation myocardial infarction/unstable angina [NSTEMI/UA], 4258 with ST-elevation myocardial infarction [STEMI]). The majority were younger (62±12years) and 76.0% were male. On admission 80.5% had ischemic chest pain lasting >20min and clinical stability. Left ventricular dysfunction was more frequent in NSTEMI/UA than in those with STEMI (30.0% vs. 10.7%, p<0.0001). In STEMI 37.6% received thrombolysis and 15.0% primary PCI. PCI was performed in 39.6% of NSTEMI/UA (early strategy in 10.8%, urgent strategy in 3.0%). Overall hospital death rate was 6.4% (8.7% in STEMI vs. 3.9% in NSTEMI/UA, p<0.001). The strongest independent predictors of hospital mortality were cardiogenic shock (odds ratio 22.4, 95% confidence interval 18.3-27.3) and ventricular fibrillation (odds ratio 12.5, 95% confidence interval 9.3-16.7). CONCLUSION: The results from RENASICA III establish the urgent need to develop large-scale regional programs to improve adherence to guideline recommendations in ACS, including rates of pharmacological thrombolysis and increasing the ratio of PCI to thrombolysis.
OBJECTIVE: To describe current management and clinical outcomes in patients hospitalized with an acute coronary syndrome (ACS) in Mexico. METHODS: RENASICA III was a prospective multicenter registry of consecutive patients hospitalized with an ACS. Patients had objective evidence of ischemic heart disease; those with type II infarction or secondary ischemic were excluded. Study design conformed to current quality recommendations. RESULTS: A total of 123 investigators at 29 tertiary and 44 community hospitals enrolled 8296 patients with an ACS (4038 with non-ST-elevation myocardial infarction/unstable angina [NSTEMI/UA], 4258 with ST-elevation myocardial infarction [STEMI]). The majority were younger (62±12years) and 76.0% were male. On admission 80.5% had ischemic chest pain lasting >20min and clinical stability. Left ventricular dysfunction was more frequent in NSTEMI/UA than in those with STEMI (30.0% vs. 10.7%, p<0.0001). In STEMI 37.6% received thrombolysis and 15.0% primary PCI. PCI was performed in 39.6% of NSTEMI/UA (early strategy in 10.8%, urgent strategy in 3.0%). Overall hospital death rate was 6.4% (8.7% in STEMI vs. 3.9% in NSTEMI/UA, p<0.001). The strongest independent predictors of hospital mortality were cardiogenic shock (odds ratio 22.4, 95% confidence interval 18.3-27.3) and ventricular fibrillation (odds ratio 12.5, 95% confidence interval 9.3-16.7). CONCLUSION: The results from RENASICA III establish the urgent need to develop large-scale regional programs to improve adherence to guideline recommendations in ACS, including rates of pharmacological thrombolysis and increasing the ratio of PCI to thrombolysis.
Authors: Manuel Chacón-Diaz; Piero Custodio-Sánchez; Paol Rojas De la Cuba; Germán Yábar-Galindo; René Rodríguez-Olivares; David Miranda-Noé; Luis Marcos López-Rojas; Akram Hernández-Vásquez Journal: BMC Cardiovasc Disord Date: 2022-06-29 Impact factor: 2.174
Authors: Héctor E Flores-Salinas; Fidel Casillas-Muñoz; Yeminia Valle; Cesar M Guzmán-Sánchez; Jorge Ramon Padilla-Gutiérrez Journal: Cardiol Res Pract Date: 2020-07-06 Impact factor: 1.866
Authors: Carmen Arroyo-Quiroz; Martin O'Flaherty; Maria Guzman-Castillo; Simon Capewell; Eduardo Chuquiure-Valenzuela; Carlos Jerjes-Sanchez; Tonatiuh Barrientos-Gutierrez Journal: PLoS One Date: 2020-12-03 Impact factor: 3.240