Revista argentina de cardiología
versión On-line ISSN 1850-3748
GAGLIARDI, Juan et al. Acute Myocardial Infarction in the Argentine Republic: Comparative Analysis of the Last 18 Years. Results of the SAC Surveys. Rev. argent. cardiol. [online]. 2007, vol.75, n.3, pp. 171-178. ISSN 1850-3748.
Objective To assess the evolution of the characteristics, therapeutic uses and in-hospital mortality of AMI patients in the last 18 years in the Argentine Republic. Material and Methods Data were captured from the SAC surveys carried out during the period 1987-2005, which included 2491 AMI patients hospitalized in Intensive Care Units throughout the country during the years 1987 (309 patients), 1991 (526 patients), 1996 (645 patients), 2000 (298 patients) and 2005 (515 patients). Results During this period, a progressive increase in the incidence of AMI non-Q type (16.7% in 1987 versus 39.8% in 2005; trend p<0.001 OR: 3.24) was observed. The time interval between the onset of symptoms and the admission varied significantly (median 4.5 hours in 1987 versus 4 hours in 2005; p<0.001) and the percentage of global use of fibrinolytics, after increasing from 12.9% in 1987 up to 41.4% in 1996, decreased down to 22.5% in 2005. Concomitantly, primary PCI increased from 2.9% in 1987 to 32.4% in 2005 (p<0.0001). In-hospital mortality showed no significant changes (11.9% in 1987 versus12.6% in 2005; p=0.36) including the different risk subgroups such as age > 75 years, female, Killip > 1, AMI type or the reperfusion strategy used. Conclusions Changes in therapy which reflect the evolution of the available evidence, mainly in regards to the inclusion of statins and clopidogrel, were observed. Increased use of primary PCI and decreased evolution times at the admission are consolidated. However, despite of these advancements, no reduction in the global in-hospital mortality was observed.
Palabras llave : Myocardial Infarction; Epidemiology; Therapy.