Mean platelet volume (MPV) is an indicator of platelet activation. High MPV has been recently considered as an independent risk factor for poor outcomes after ST-segment elevation myocardial infarction (STEMI). We analyzed 128 patients diagnosed with first STEMI successfully reperfused during three consecutive years. MPV was measured on admission and a cardiac magnetic resonance (CMR) exam was performed within the first week in all patients. Myocardial necrosis size was estimated by the area of late gadolinium enhancement (LGE), identifying microvascular obstruction (MVO), if present. Clinical outcomes were recorded at 1 year follow-up. High MPV was defined as a value in the third tertile (≥9.5 fl), and a low MPV, as a value in the lower two. We found a slight but significant correlation between MPV and infarct size (r = 0.287, P = 0.008). Patients with high MPV had more extensive infarcted area (percentage of necrosis by LGE: 17.6 vs. 12.5%, P = 0.021) and more presence of MVO (patients with MVO pattern: 44.4 vs. 25.3%, P = 0.027). In a multivariable analysis, hazard ratio for major adverse cardiac events was 3.35 [95% confidence interval (CI) 1.1-9.9, P = 0.03] in patients with high MPV. High MPV in patients with first STEMI is associated with higher infarct size and more presence of MVO measured by CMR.

This study confirms the relevant prevalence of MVD in STEMI patients, as well as the difference in outcomes of an IR strategy between both age-groups, being only independently associated with MACE in younger patients. This finding supports that a routine complete revascularization (CR) strategy seems to be the best therapeutic option in younguer patients, whereas in the elderly population may not confer a clear clinical benefit during a long-term follow-up.

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Este libro surge de una experiencia inédita para los países andinos de Latinoamérica: la recepción de más de cuatro millones de migrantes venezolanos en Colombia, Ecuador, Perú y Chile a partir del año 2017. Los estudios recogidos en este volumen han sido preparados para cada uno de estos países por la Red sobre Salud y Migraciones (SAMI) y partieron de la premisa de que había que complementar la primera generación de investigaciones sobre la migración venezolana —que se había centrado en dimensionar el fenómeno con reportes sociodemográficos y privilegió estudios puntuales— con el fin de producir estados de situación nacionales que permitan a los gobiernos mejorar la respuesta institucional frente al tema de las migraciones. El balance general es positivo: pese a todas las dificultades previas de estos países para cubrir la brecha entre las necesidades de la población nacional y la oferta de sus entidades proveedoras de servicios, estos han asumido el nuevo desafío humanitario y de salud de la migración venezolana, y desarrollado iniciativas para compartir lo que tenían con los recién llegados.

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