Mortalidad intrahospitalaria en hombres y mujeres según terapias de reperfusión en infarto agudo del miocardio con supradesnivel del ST / ln-hospital mortality after ST-segment elevation myocardial infarction according to reperiusion therapy
Rev. méd. Chile
;
136(2): 143-150, feb. 2008. tab
Artigo
em Espanhol
| LILACS
| ID: lil-483232
ABSTRACT
Primary angioplasty is considered the best reperiusion therapy in the treatment of ST-segment elevation myocardial infarction (STEMI). However, thrombolysis is the reperiusion method most commonly used, due to its wide availability, reduced costs and ease of administration. Aim: To compare inhospital mortality in STEMI patients according to reperiusion therapy. Material and Methods: Patients admitted to Chilean hospitals participating in the GEMI network, from 2001 to 2005, with STEMI were included. They were divided in three groups: a) treated with thrombolytics, b) treated with primary angioplasty, c) without reperiusion procedure. Inhospital mortality according to gender, was analized in each group, using a logistic regression method, to assess risk factors associated with mortality. Results: We included 3,255 patients. Global mortality was 9.9 percent (7.5 percent in men and 16.7 percent in women, p <0.001). Mortality in patients treated with thrombolytics, was 10.2 percent (7.6 percent in men and 18.7 percent in women, p <0.01). The figure for patients treated with primary angioplasty, was 4.7 percent (2.5 percent in men and 13 percent in women, p <0.01), and in patients without reperiusion, was 11.6 percent (9.8 percent in men and in 15.4 percent women, p <0.01). In each group women were older, had a higher prevalence of hypertension and a higher percentage of Killip 3-4 infarctions. Logistic regression showed that angioplasty, compared with no reperiusion, was associated with a reduced mortality only in men. The use oí thrombolytics in women was associated with a higher mortality. Conclusions: Primary angioplasty was the reperiusion therapy associated to the lower mortality in STEMI. Use of thrombolytics in women was associated with a higher mortality rate than in non reperfused women.
Texto completo:
DisponíveL
Índice:
LILACS (Américas)
Assunto principal:
Angioplastia Coronária com Balão
/
Terapia Trombolítica
/
Mortalidade Hospitalar
/
Infarto do Miocárdio
Tipo de estudo:
Ensaio Clínico Controlado
/
Estudo de etiologia
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Estudo prognóstico
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Fatores de risco
Limite:
Feminino
/
Humanos
/
Masculino
Idioma:
Espanhol
Revista:
Rev. méd. Chile
Assunto da revista:
Medicina
Ano de publicação:
2008
Tipo de documento:
Artigo
País de afiliação:
Chile
Instituição/País de afiliação:
Hospital de Urgencias de la Asistencia Pública/CL
/
Pontificia Universidad Católica de Chile/CL
/
Universidad de Chile/CL
/
Universidad de La Frontera/CL
/
Universidad de Los Andes/CL
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