Pharmaco-invasive approach in the management of acute myocardial infarction. Analysis of 144 cases
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2022-12
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Facultad/escuela
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es
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Sociedad Medica de Santiago
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CC BY 4.0 DEED
Attribution 4.0 International
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https://creativecommons.org/licenses/by/4.0/deed.en
Resumen
Background: In those patients who do not have timely access to primary angioplasty, the pharmaco-invasive approach, that is, the use of thrombolysis as a bridging measure prior to the coronary angiography, is a safe alternative. Aim: To describe the features of patients with an acute ST-elevation myocardial infarction (STEMI) treated with a pharmaco-invasive strategy. Material and Methods: Descriptive observational study of 144 patients with mean age of 46 years with STEMI who received a dose of thrombolytic prior to their referral for primary angioplasty at a public hospital between 2018 and 2021. Results: There were no differences the clinical presentation according to the Killip score at admission between thrombolyzed and non-thrombolyzed patients (p = ns). Fifty-three percent of non-thrombolyzed patients were admitted with an occluded vessel (TIMI 0) compared with 27% of thrombolyzed patients (p < 0.001). The thrombolyzed group required significantly less use of thromboaspiration (3.5 and 8.4% respectively; p = 0.014). Despite this, 91 and 92% of non-thrombolyzed and thrombolyzed patients achieved a post-angioplasty TIMI 3 flow. Long-term survival was 91 and 86% in thrombolyzed and non-thrombolyzed patients, respectively (p = ns). Conclusions: The pharmaco-invasive strategy is a safe alternative when compared to primary angioplasty in centers that don`t have timely access to Interventional Cardiology. © 2022 Sociedad Medica de Santiago. All rights reserved.
Notas
Indexación: Scopus.
Palabras clave
Angioplasty, Balloon, Coronary, Myocardial Infarction, Thrombolytic Therapy, Coronary Angiography, Fibrinolytic Agents, Humans, Middle Aged, ST Elevation Myocardial Infarction, Treatment Outcome
Citación
Revista Medica de Chile, Volume 150, Issue 12, Pages 1619 - 1624, December 2022
DOI
10.4067/S0034-98872022001201619