Manuel Chacón-Diaz1, Alejandro Vega2, Ofelia Aráoz2, Patricia Ríos3, Roberto Baltodano4, Fernando Villanueva4, Alexander Montesinos5, Jorge Martos6, John Zevallos7, David Miranda8, Jorge Gutierrez9, José Carasas10, Alex Pecho11, Sandra Negrón12, Henry Anchante13, Nassip Llerena14, German Yabar15, Javier Chumbe16, Sara Ramírez17, Marco Lazo18, Jorge Sotomayor19, Marco López20, Carlos Perez21. 1. Servicio de Cardiología Clínica, Instituto Nacional Cardiovascular (INCOR), Lima, Perú; Clínica Delgado-AUNA, Lima, Perú. Electronic address: manuelchacon03@yahoo.es. 2. Servicio de Cardiología Clínica, Instituto Nacional Cardiovascular (INCOR), Lima, Perú. 3. Servicio de Cardiología, Hospital Nacional Edgardo Rebagliati Martins, Lima, Perú. 4. Servicio de Cardiología, Hospital Nacional Guillermo Almenara Irigoyen, Lima, Perú. 5. Hospital Adolfo Guevara, EsSALUD, Cusco, Perú. 6. Hospital del Ministerio de Salud, Cajamarca, Perú. 7. Hospital Daniel A. Carrión, Ministerio de Salud, Callao, Perú. 8. Clínica San Felipe, Lima, Perú. 9. Hospital Honorio Delgado, Ministerio de Salud, Arequipa, Perú. 10. Hospital Almanzor Aguinaga, EsSALUD, Chiclayo, Perú. 11. Hospital Augusto Hernandez, EsSALUD, Ica, Perú. 12. Clínica Internacional, Lima, Perú. 13. Hospital Nacional Cayetano Heredia, Ministerio de Salud, Lima, Perú. 14. Hospital Carlos A. Seguín, EsSALUD, Arequipa, Perú. 15. Clínica San Pablo, Lima, Perú. 16. Hospital Nacional Arzobispo Loayza, Ministerio de Salud, Lima, Perú. 17. Hospital Central de la Fuerza Aérea del Perú, Lima, Perú. 18. Hospital Ramiro Prialé, EsSALUD, Huancayo, Perú. 19. Hospital de Juliaca, EsSALUD, Juliaca, Puno, Perú. 20. Hospital Alberto Sabogal Sologuren, EsSALUD, Callao, Perú. 21. Departamento de Enfermería, Instituto Nacional Cardiovascular (INCOR), Lima, Perú.
Abstract
OBJECTIVE: To determine the epidemiological characteristics, treatment, reperfusion strategies and in-hospital adverse events of patients with ST elevation myocardial infarction in Peru. METHODS: Observational, prospective multicentre study in patients over 18 years admitted to hospital with a diagnosis of ST elevation myocardial infarction. RESULTS: A total of 396 patients were enrolled in the registry during February 2016 to February 2017. The mean age was 64.9±12 years, and 21% were women. In the first 12h of onset 38% of patients were fibrinolysed, 29% underwent primary PCI, and 33% did not receive any reperfusion. Pharmaco-invasive strategy was used in 12.9% of cases. The fibrinolysis was successful in 65% of patients, and primary PCI success was 82%. The hospital stay was 6 days (IQR 5-10). In-hospital mortality was 10.1%, with the first cause of death being due to cardiogenic shock. The rate of in-hospital re-infarction was 2.2%, and the rate of acute heart failure was 25%. Age>75 years, large infarct size, left ventricular ejection fraction<40%, and absence of negative T waves on post-reperfusion electrocardiogram were independently related to higher in-hospital mortality. CONCLUSIONS: In Peru, ST elevation myocardial infarction most frequently affects men between 60-70 years. The most frequent initial reperfusion treatment is fibrinolysis, followed by primary angioplasty, and pharmaco-invasive strategy. The main reason for the lack of administration of reperfusion treatment was the delay from symptoms onset to first medical contact. The most common cause of in-hospital death was cardiogenic shock.
OBJECTIVE: To determine the epidemiological characteristics, treatment, reperfusion strategies and in-hospital adverse events of patients with ST elevation myocardial infarction in Peru. METHODS: Observational, prospective multicentre study in patients over 18 years admitted to hospital with a diagnosis of ST elevation myocardial infarction. RESULTS: A total of 396 patients were enrolled in the registry during February 2016 to February 2017. The mean age was 64.9±12 years, and 21% were women. In the first 12h of onset 38% of patients were fibrinolysed, 29% underwent primary PCI, and 33% did not receive any reperfusion. Pharmaco-invasive strategy was used in 12.9% of cases. The fibrinolysis was successful in 65% of patients, and primary PCI success was 82%. The hospital stay was 6 days (IQR 5-10). In-hospital mortality was 10.1%, with the first cause of death being due to cardiogenic shock. The rate of in-hospital re-infarction was 2.2%, and the rate of acute heart failure was 25%. Age>75 years, large infarct size, left ventricular ejection fraction<40%, and absence of negative T waves on post-reperfusion electrocardiogram were independently related to higher in-hospital mortality. CONCLUSIONS: In Peru, ST elevation myocardial infarction most frequently affects men between 60-70 years. The most frequent initial reperfusion treatment is fibrinolysis, followed by primary angioplasty, and pharmaco-invasive strategy. The main reason for the lack of administration of reperfusion treatment was the delay from symptoms onset to first medical contact. The most common cause of in-hospital death was cardiogenic shock.
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