Juan P. Costabel, Consejo de Emergencias Cardiovasculares; Sociedad Latinoamericana de Cardiología Intervencionista
Joaquín Perea, Consejo de Emergencias Cardiovasculares; Sociedad Latinoamericana de Cardiología Intervencionista
Miguel Quintana, Consejo de Emergencias Cardiovasculares; Sociedad Latinoamericana de Cardiología Intervencionista
Pablo Lamelas, Consejo de Cardiología Intervencionista; Sociedad Latinoamericana de Cardiología Intervencionista
Ignacio Vaca-Valverde, Consejo de Cardiología Intervencionista; Sociedad Latinoamericana de Cardiología Intervencionista
Alfonsina Candiello, Iniciativa Stent Save a Life
Patricio Sanhueza, Consejo de Emergencias Cardiovasculares; Sociedad Latinoamericana de Cardiología Intervencionista
Alexandra Arias, Consejo de Emergencias Cardiovasculares; Sociedad Latinoamericana de Cardiología Intervencionista
Iván Saavedra, Consejo de Emergencias Cardiovasculares; Sociedad Latinoamericana de Cardiología Intervencionista
Alex Rivera-Toquica, Consejo de Emergencias Cardiovasculares; Sociedad Latinoamericana de Cardiología Intervencionista
Marildes L. de Castro, Consejo de Emergencias Cardiovasculares; Sociedad Latinoamericana de Cardiología Intervencionista
Manuel Álvarez, Consejo de Emergencias Cardiovasculares; Sociedad Latinoamericana de Cardiología Intervencionista
Ricardo Villarreal, Consejo de Emergencias Cardiovasculares; Sociedad Latinoamericana de Cardiología Intervencionista
Introduction: The management of patients with ST-elevation myocardial infarction (STEMI) presents diverse realities, not only among countries but also among different regions within the same country. A survey was conducted with the aim of understanding how patients with STEMI are treated in Latin America. Method: A cross-sectional cohort study was conducted through a survey consisting of 10 questions that could be answered in both Spanish and Portuguese. The data collection took place over two consecutive months, from March 1st to April 30th, 2022. Results: A total of 412 respondents representing centers from 20 countries in the Americas were recorded: 48% reported using primary angioplasty, 23% fibrinolytic, 21% a combination of fibrinolytic and primary angioplasty, and 8% referred patients for reperfusion to another center. When inquiring about the availability of fibrinolytic agents, alteplase was the most common (55%), followed by streptokinase (35%), and tenecteplase (28%). 7% of the total surveyed centers did not have any fibrinolytic agents, 69% reported transferring all their patients to a higher complexity center for coronary angiography after the administration of lytics (pharmaco-invasive strategy), 22% only transferred selected patients, and 9% did not transfer any patients. 52% reported working in coordination with ambulance services, and 54% actively measured reperfusion times and patient mortality. Conclusions: The survey reveals the reality of centers where primary angioplasty is the preferred method of reperfusion, followed by fibrinolysis primarily with alteplase and streptokinase. The pharmaco-invasive strategy seems to be used less than recommended, as well as coordination with ambulance services and continuous measurement of times to identify improvement opportunities.
Keywords: Myocardial infarction. Angioplasty. Fibrinolytic agents. ST elevation myocardial infarction.