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Revista argentina de cardiología

versión On-line ISSN 1850-3748


ROSSI PRAT, Mauro et al. Use of the Pharmacoinvasive Strategy in Argentina. ARGEN-IAM ST Registry Analysis. Rev. argent. cardiol. [online]. 2023, vol.91, n.3, pp.252-257. ISSN 1850-3748.


Primary percutaneous coronary intervention (PPCI) is the treatment of choice for acute ST elevation myocardial infarction (STEMI). In Argentina, a country with a large area and suboptimal reperfusion times, the pharmacoinvasive (PI) strategy might be considered.


ARGEN-IAM-ST is a national prospective, multicenter, and observational registry that includes STEMI patients with less than 36 hours of progression. The PI strategy usage and its associated variables were defined.


In this registry, 4788 patients were analyzed, of which 88.56% underwent PPCI, 8.46% received thrombolytics with positive reperfusion (TL+), and only 2.98% received PI strategy.

Median and interquartile range (IQR) of total ischemia time were lower in patients receiving TL+ (165 min, IQR 100-269) and PI (191 min, IQR 100-330) than in patients undergoing PPCI (280 min, IQR 179-520), p <0.001.

No differences in intra-hospital mortality were observed: 4.9% in the PI strategy group, 5.2% in the TL+ group and 7.8% in the PPCI group (p = 0.081). No differences in major bleeding events were observed.

It was observed that 57% of the TL+ patients met the criteria for high cardiovascular risk, but they did not receive PI strategy, as recommended.


Only 3 out of 100 reperfused STEMI patients received PI strategy. Its administration is not systematically associated to high cardiovascular risk.

Despite the under-usage, it remains an option to be considered due to its total ischemia time lower than in the PPCI, with no increase in clinically significant bleedings.

Palabras clave : Myocardial infarction; ST-elevation myocardial infarction; Mortality; Reperfusion; Thrombolytics; Angioplasty.

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