Utilización de la trombólisis en los pacientes con infarto agudo de miocardio en España: observaciones del estudio PRIAMHO

Bosch, Xavier; Sambola, Antonia; López-Bescós, Lorenzo; Mancisidor, Xabier; Illa, Jaume; Claramonte, Ramón

doi:10.1016/s0300-8932(00)75118-9

Cited by 28 publications

(5 citation statements)

References 35 publications

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“…The lower use of thrombolysis, antiplatelet therapy and coronary angiography partially explained this higher case-fatality. In our study, the overall use of thrombolysis (43%) was less than that observed in series of patients admitted to the CCU, 23 particularly in basic hospitals (6.4%). The same conclusions are obtained when analyzing the use of antiplatelet therapy, beta-blockers, and ACE inhibitors.…”

Section: Type Of Hospital Admission To a Ccu And Case-fatalitycontrasting

confidence: 69%

Hospital Resources and Myocardial Infarction Case Fatality. The IBERICA Study

Álvarez-León¹,

Elosúa²,

Zamora³

et al. 2004

Revista Española de Cardiología (English Edition)

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Introduction and objectives. To determine the proportion of patients with myocardial infarction (MI) not admitted to a coronary care unit (CCU), the variables associated with admission into a CCU, and whether admission to a CCU, and the availability of coronary angiography in the same hospital, were associated with 28-day case fatality. Patients and method. Population-based registry of MI in patients 25 to 74 years of age, admitted during 1996-1998. Demographic and clinical characteristics were recorded, as well as management, clinical course and survival after 28 days. Hospitals were classified according to the availability of a CCU and catheterization laboratory (advanced hospital), CCU only (intermediate hospital) or neither (basic hospital). Admission to the CCU was also recorded. Results. In all, 9046 cases of MI were recorded; in 11.3% the patient was not admitted to a CCU. Age, smoking (OR=1.33; 95% CI, 1.08-1.64), non-Q MI (OR=0.62; 95% CI, 0.49-0.78) or undetermined location of MI (OR=0.34; 95% CI, 0.23-0.50), Killip 4 score on admission (OR=0.63; 95% CI, 0.40-1.00) and delay in arrival at the hospital >6 h were associated with CCU admission. Patients admitted to a CCU showed a lower case fatality in the first 24 h (4.2% vs 23.5%), which was independent of comorbidity, severity and treatment. The 24-hour survivors admitted to a basic hospital had higher case fatality (17.3% vs 7.8%) than other groups, which was related to differences in treatment. Conclusions. CCU admission is associated with a lower case fatality in the first 24 h. Admission to a basic hospital is associated with a higher 28-day case fatality even in patients who survive 24 h. Resumen Introducción y objetivos. Determinar el porcentaje de pacientes con infarto agudo de miocardio (IAM) que no ingresan en una unidad de cuidados intensivos coronaries (UCIC), las variables asociadas al ingreso en una UCIC y si el ingreso en una UCIC, su disponibilidad y la de hemodinámica en el hospital se asocian a la letalidad a 28 días. Pacientes y método. Registro poblacional (1996-1998) de casos de IAM en pacientes con edades comprendidas entre los 25 y los 74 años. Se recogieron variables demográficas, clínicas, el ingreso en UCIC y la letalidad a los 28 días. Se clasificaron los hospitales según la disponibilidad de UCIC y hemodinámica (hospital avanzado), solamente UCIC (hospital intermedio) o ninguno (hospital básico). Resultados. Se registraron 9.046 casos; el 11,3% no ingresó en una UCIC. La edad, el consumo de tabaco (odds ratio [OR] = 1,33; intervalo de confianza [IC] del 95%, 1,08-1,64), el infarto sin onda Q (OR = 0,62; IC del 95%, 0,49-0,78) o ilocalizable (OR = 0,34; IC del 95%, 0,23-0,50), el grado Killip 4 al ingreso (OR = 0,63; IC del 95%, 0,40-1,00) y el retraso > 6 h en llegar al hospital se asociaron al ingreso en UCIC. Los pacientes ingresados en UCIC presentaban menor letalidad que los ingresados en hospitales básicos en las primeras 24 h (el 4,2 frente al 23,5%), independientemente de la gravedad del IAM y de las variables relaciona...

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Section: Type Of Hospital Admission To a Ccu And Case-fatalitycontrasting

confidence: 69%

Hospital Resources and Myocardial Infarction Case Fatality. The IBERICA Study

Álvarez-León¹,

Elosúa²,

Zamora³

et al. 2004

Revista Española de Cardiología (English Edition)

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“…In a study carried out in London on 1,225 patients, the percentage of fibrinolysis in patients younger than 50 years (190 patients) was 82.6% and decreased to 66% in the group aged 70–79 years [16]. Indeed, the percentage of patients with ST-elevation who receive reperfusion therapy in our country has increased from 56% in 1995 [17] to 71.6% in 2000 [2]. …”

Section: Discussionmentioning

confidence: 99%

Characteristics and Outcome of Acute Myocardial Infarction in Young Patients

Morillas

Bertoméu

Pabón³

et al. 2006

Cardiology

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Background: The objective was to analyze the incidence, risk factors, management, and complications of acute myocardial infarction (AMI) in the young patient in Spain. Methods: Clinical characteristics, treatment, and outcome were analyzed in patients younger than 45 years admitted with an AMI diagnosis to the Coronary Units of 58 Spanish hospitals from 15th May to 15th December 2000. Results: Six thousand two hundred and ten consecutive patients were registered, 7% out of them were <45 years old. Outcome was better in the younger group, with a lower mortality rate at 28 days (3.7 vs. 11.9%; p < 0.001), demonstrating that age <45 years is an independent protective factor for mortality (relative risk: 0.41; 95% CI: 0.23–0.73; p < 0.001). This difference remained at 1-year follow-up. Conclusions: AMI in young patients presents distinct clinical characteristics, a different treatment, management and outcome with respect to the older group.

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“…El subregistro TRIANA 1 fue planteado para analizar a todos los pacientes con IAM tratados de manera consecutiva con ICP en una serie de centros seleccionados en España y durante un período preestablecido. Datos extrapolados de registros españoles en relación con el tratamiento del IAM transmural sugieren que en el año 2002 sólo un 10-15% de pacientes ingresados en hospitales fue reperfundido mediante angioplastia primaria [10][11][12][13] . Sin embargo, en el subregistro TRIANA 1, la inclusión tuvo que interrumpirse un mes antes del período previsto por haberse alcanzado el tamaño de muestra calculado.…”

Section: Discussionunclassified

“…Debe tratarse de un estudio multicéntrico, aleatorizado, en el que la selección de los pacientes sea mínima pero que se efectúe en una población con una elevada morbilidad y mortalidad. La Sección de Hemodinámica y Cardiología Intervencionista y la Sección de Cardiopatía Isquémica y Unidades Coronarias de la Sociedad Española de Cardiología promueven registros periódicos para determinar diferentes aspectos relacionados con determinadas incidencias y formas de manejo de los pacientes con enfermedad coronaria [7][8][9][10][11] . El Registro TRIANA (TRatamiento del Infarto Agudo de miocardio eN Ancianos) fue planteado para determinar la factibilidad de realizar un estudio aleatorizado para comparar la eficacia del intervencionismo coronario percutáneo (ICP) en comparación con la trombólisis en el tratamiento del IAM en pacientes de edad avanzada (edad ≥ 75 años).…”

Section: A R D I O L O G í a I N T E Rv E N C I O N I S Taunclassified