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Angioplastia primaria en el infarto agudo de miocardio: predictores de eventos en el seguimiento de largo plazo.;
Primary Percutaneous Coronary Intervention in Acute Myocardial Infarction: Long-Term Predictors of Adverse Events

Creators:Alvarez, José; Servicio de Hemodinamia y Cardioangiología Intervencionista del Hospital Británico de Buenos Aires.
Servicio de Hemodinamia y Cardioangiología Intervencionista del Hospital Alemán de Buenos Aires, Migliaro, Guillermo, Leiva, Gustavo, Allin, Jorge, Baglioni, Pablo, Fernandez Recalde, Maria Luz; Servivio de Hemodinamia y Cardiologia Intervencionista, Hospital Aleman, Hospital Britanico de Buenos Aires, Avaca, Horacio, Deketele, Felipe
2014-10-07

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Descripción

RESUMEN Fundamentos El Infarto Agudo de Miocardio (IAM) es una de las principales causas de muerte  cardiovascular (MCV). Los tratamientos de reperfusión, aplicados dentro de las primeras horas del evento, han contribuido a disminuir significativamente esa mortalidad. No existen en nuestro país registros con seguimiento a largo plazo de pacientes con IAM tratados con Angioplastia Transluminal Coronaria Primaria (ATCp) Introducción y Objetivos Evaluar el pronóstico alejado de pacientes sometidos a ATCp por IAM con supradesnivel ST (IAMcST) y su relación con  las principales variables clínicas y terapéuticas aplicadas en diferentes décadas (1993-2002 vs 2003-2012) y con los resultados intrahospitalarios. Material y Métodos Se realizó un estudio observacional y retrospectivo de todos los pacientes con diagnóstico de IAMCST a quienes se les realizó una ATCp en dos hospitales de comunidad entre los años 1993 y  2012. Resultados Se incluyeron 851 pacientes (p) ingresados consecutivamente entre los años 1993 y 2012. La edad promedio fue de 61±12 años y la mediana de seguimiento de 7.8 años en el 85% de la población. La mortalidad intrahospitalaria (MIH) total fue del 6%, y del 1.6% cuando se excluyeron los pacientes con shock al ingreso; las variables independientes asociadas fueron la edad (OR 1.06 IC 1.03-1.09 p&lt;.001), el sexo femenino (OR 3.1 IC 1.5-6.2 p&lt;.002), la Diabetes Mellitus (DM) (OR 3.9 IC 1.86-8 p&lt;.001), y la enfermedad de tres vasos coronarios (OR 4.3 IC 2.1-8.6 p&lt;.001); el flujo final TIMI 3 fue una variable predictora de menor MIH (OR 0.28 IC 0.08-0.11 p&lt;.008). La mortalidad global en el seguimiento (MG) fue de 14.3%, y los predictores independientes fueron la edad (OR 3.1 IC 1.8-5.5 p&lt;.001), la DM (OR 2.3 IC 1.25-4.3 p&lt;.007), y el KK C o D al ingreso (OR 4 IC 1.7-9 p&lt;.001); la utilización de stent se asoció con menor  alejada (OR 0.35 IC 0.21-0.6 p&lt;.001). Conclusiones En este grupo de pacientes con IAMcST la ATCp aplicada adecuadamente y una elevada tasa de seguimiento alejado permitió obtener resultados intrahospitalarios favorables que se mantienen en el largo plazo.  La comparación entre los pacientes asistidos en la primera década con los de la segunda muestra una tendencia no significativa a menor MIH a pesar de tratarse de un grupo de mayor riesgo.

performed within the first hours have contributed to produce a significant reduction in mortality. In our country, there areno long-term follow-up registries of AMI patients treated with primary percutaneous coronary intervention (PCI).Objectives: The aim of this study is to evaluate the in-hospital results and long-term outcome of ST-segment elevation AMI(STEMI) patients undergoing primary PCI and their correlation with the main clinical and therapeutic variables applied indifferent decades (1993-2002 vs. 2003-2012).Methods: We performed an observational and retrospective study of all STEMI patients undergoing primary PCI in two communityhospitals between 1993 and 2012.Results: The study included 851 patients consecutively admitted between 1993 and 2012. Mean age was 61 ± 12 years andmedian follow-up was 7.8 years in 85% of the population. In-hospital mortality was 6% and 1.6% when patients with shock atadmission were excluded. It was independently associated with age (OR 1.06, CI 1.03-1.09; p &lt; 0.001), female sex (OR 3.1, CI 1.5-6.2; p &lt; 0.002), diabetes mellitus (OR 3.9, CI 1.86-8; p &lt; 0.001) and three-vessel disease (OR 4.3, CI 2.1-8.6; p &lt; 0.001).Conversely, final TIMI grade 3 flow predicted lower in-hospital mortality (OR 0.28, CI 0.08-0.11; p &lt; 0.008). During follow-up,overall mortality was 14.3% and the independent predictors were age (OR 3.1, CI 1.8-5.5; p &lt; 0.001), diabetes mellitus (OR2.3, CI 1.25-4.3; p &lt; 0.007) and Killip and Kimball (KK) class C or D at admission (OR 4, CI 1.7-9; p &lt; 0.001); stent implantwas associated with lower overall long-term mortality (OR 0.35, CI 0.21-0.6; p &lt; 0.001).Conclusions: In this group of STEMI patients, the adequate use of primary PCI and the high rate of patients at long-termfollow-up allowed the collection of favorable in-hospital and long-term results. Advanced age at the moment of STEMI, diabetesmellitus, female sex and multiple vessel disease were predictors of in-hospital mortality, while age, diabetes mellitus and KKclass C or D were independent predictors of mortality during follow-up. Patients treated during the second decade showed anon-significant trend towards reduced in-hospital mortality compared with those of the first decade.

Metadatos destacados

Colecciones
Argentine Journal of Cardiology

Editor

Sociedad Argentina de Cardiología

Fuente

Revista Argentina de Cardiología; Vol 82, No 5 (2014); 381-388, Argentine Journal of Cardiology; Vol 82, No 5 (2014); 381-388

Citación

Alvarez, José; Servicio de Hemodinamia y Cardioangiología Intervencionista del Hospital Británico de Buenos Aires. Servicio de Hemodinamia y Cardioangiología Intervencionista del Hospital Alemán de Buenos Aires et al., “Angioplastia primaria en el infarto agudo de miocardio: predictores de eventos en el seguimiento de largo plazo.,” Archivo PPCT, consulta 2 de abril de 2026, http://archivoppct.caicyt.gov.ar/items/show/8401.

Dublin Core

Materia

Autor

Alvarez, José; Servicio de Hemodinamia y Cardioangiología Intervencionista del Hospital Británico de Buenos Aires.
Servicio de Hemodinamia y Cardioangiología Intervencionista del Hospital Alemán de Buenos Aires
Migliaro, Guillermo
Leiva, Gustavo
Allin, Jorge
Baglioni, Pablo
Fernandez Recalde, Maria Luz; Servivio de Hemodinamia y Cardiologia Intervencionista, Hospital Aleman, Hospital Britanico de Buenos Aires
Avaca, Horacio
Deketele, Felipe

Fuente

Revista Argentina de Cardiología; Vol 82, No 5 (2014); 381-388
Argentine Journal of Cardiology; Vol 82, No 5 (2014); 381-388

Editor

Sociedad Argentina de Cardiología

Fecha

2014-10-07

Derechos

Los que firman al pié, certificamos que tenemos total responsabilidad por la conducción de este estudio y por el diseño y la interpretación de los datos. Nosotros escribimos el manuscrito y somos responsables por la decisión acerca del mismo. Cada uno de nosotros cumple la definición de autor como se afirma en el Comité Internacional de Editores de Revistas Médicas (International Committee of Medical Journal Editors, ver www.icmje.org). Nosotros hemos visto y aprobado el manuscrito final. Ni el artículo, ni ninguna parte esencial del mismo, incluido las tablas y las figuras, será publicado o admitido para arbitrar a otra parte antes de aparecer en la Revista.También notificamos haber leído la sección “conflicto de intereses”, y revelaríamos cualquiera que existiera. Dejamos constancia que si nuestro artículo se publicara en la RAC, cederíamos los derechos (copyright) a la Revista.Los documentos publicados en esta revista están bajo la licencia Creative Commons Atribución-NoComercial-Compartir-Igual 2.5 Argentina.
Those signing below certify that we have full responsibility for the conduction of this study and for the design and interpretation of the information. We wrote the manuscript and are responsible for its decision. Each of us fulfills the definition of authorship as stated by the International Committee of Medical Journal Editors ( www.icmje.org). We have signed and approved the final manuscript. Neither the manuscript, nor any essential part thereof, including tables and figures, will be published or accepted for refereeing elsewhere before being published in the Journal. We have also read the "Conflict of Interest" section and would disclose any existing. We state that if our manuscript is published in the RAC, we shall transfer the copyright to the Journal.

Formato

Idioma

spa
eng

Tipo

info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion