Mortalidad intrahospitalaria en hombres y mujeres según terapias de reperfusión en infarto agudo del miocardio con supradesnivel del ST

• Juan Carlos Prieto ^[1] ; Consuelo Sanhueza ^[1] ; Nicolás Martínez ^[1] ; Carolina Nazzal ^[1] ; Ramón Corbalán ^[2] ; Gabriel Cavada ^[1] ; Fernando Lanas ^[3] ; Jorge Bartolucci ^[4] ; Pabla Campos ^[5]
  1. [1] Universidad de Chile

     Universidad de Chile

     Santiago, Chile

     
  2. [2] Pontificia Universidad Católica de Chile

     Pontificia Universidad Católica de Chile

     Santiago, Chile

     
  3. [3] Universidad de La Frontera

     Universidad de La Frontera

     Temuco, Chile

     
  4. [4] Universidad de Los Andes

     Universidad de Los Andes

     Colombia

     
  5. [5] Hospital de Urgencias de la Asistencia Pública

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• Localización: Revista Médica de Chile, ISSN-e 0034-9887, Vol. 136, Nº. 2, 2008, págs. 143-150
• Idioma: español
• Títulos paralelos:
  • ln-hospital mortality after ST-segment elevation myocardial infarction according to reperiusion therapy
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• Resumen

  • 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% (7.5% in men and 16.7% in women, p <0.001). Mortality in patients treated with thrombolytics, was 10.2% (7.6% in men and 18.7% in women, p <0.01). The figure for patients treated with primary angioplasty, was 4.7% (2.5% in men and 13% in women, p <0.01), and in patients without reperiusion, was 11.6% (9.8% in men and in 15.4% 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