medigraphic.com

2002, Number S2

<< Back

Arch Cardiol Mex 2002; 72 (S2)

National Registry of Acute Ischemic Coronary Syndromes in Mexico. [RENASICA]

Language: Spanish
References: 73
Page: 45-64
PDF size: 181.34 Kb.


ABSTRACT

This study assessed current practices in relation to coronary risk factors, therapy and its results in patients with acute ischemic coronary syndromes (AICS) with or without ST-segment-elevation myocardial infarction [MI], from data collected in the National Registry of AICS [RENASICA] in México; Eigh teen hospitals [2nd. and 3rd level of medical attention] recruited patients for the registry, 4,253 patiens were enrolled, 2,773 [65.2%] without AICSST segment elevation and 1480 [34.8%] patients with ST segment elevation MI. Chest pain was the main cause for seeking medical attention to an emergency service (90.5%) and 50% of the patients referred it in advance. AICS was mainly observed in men in their sixth decade of age. Age, ST segment depression [› 2 mm], CKMB [› 2 values above normal] and the extension of the coronary artery disease allow to predict mortality and the combination of mortality and myocardial infarction. Only 50.4% of the eligible patients with AICS and ST-segment-elevation myocardial infarction received thrombolytic therapy. Of the eligible cohort of AICS only 58% patients could an hemodynamic study be performed. In 55% of them, a percutaneous coronary intervention procedure was done (PTCA-Stent implantation). Aspirin [ASA] and heparin were prescribed in 70% of the patients at entry to the ward and the same percentage of AICS patients received ASA after discharge. Low molecular weight heparin and IIb/IIIa receptor platelet antagonists were used in a low proportion of patients. RENASICA provides information related to AICS patients that could help the mexican health authorities to apply better the health resources in the forthcoming future for the treatment of AICS.


REFERENCES

  1. Causas de mortalidad en México 2000. Estadísticas de Mortalidad, Secretaría de Salud. http://www.ssa.gob.mx.

  2. Braunwald E, Mark DB, Jones RH: Unstable angina: diagnosis and management. Rockville, MD: Agency for Health Care Policy and Research and the National Heart, Lung, and Blood Institute, US Public Health Service, US Department of Health and Human Services; 1994: 1. AHCPR Publication 94-0602.

  3. National Center for Health Statistics. Detailed diagnoses and procedures: National Hospital Discharge Survey, 1996. Hyattsville, MD: National Center for Health Statistics; 1998: 13. Data from Vital and Health Statistics.

  4. Nourjah P: National Hospital Ambulatory Medical Care Survey:1997 emergency department summary. Hyattsville, MD: National Center for Health Statistics; 1999: 304. Advance data from Vital and Health Statistics.

  5. Anderson HV, Cannon CP, Stone PH, Williams DO, McCabe CH , Knatterud GL, et al: One-year results of the Thrombolysis In Myocardial Infarction (TIMI) IIIB clinical trial: a randomized comparison of tissue-type plasminogen activator versus placebo and early invasive versus early conservative strategies in unstable angina and non-Q wave myocardial infarction. J Am Coll Cardiol 1995; 26: 1643-1650.

  6. Davies MJ, Thomas AC, Knapman PA, Hangartner JR: Intramyocardial platelet aggregation in patients with unstable angina suffering sudden ischemic cardiac death. Circulation 1986; 73: 418–427.

  7. Frink RJ, Rooney PA Jr, Trowbridge JO, Rose PJ: Coronary thrombosis and platelet/fibrin microemboli in death associated with acute myocardial infarction. Br Heart J 1988; 59: 196–200.

  8. Furman MI, Dauerman HL, Goldberg RJ, Yarzbeski J, Lessard D, Gore JM: Twenty –Two Year (1975 to 1997) Trens in the Incidence , In –Hospital and long-term Case fatality Rates From Initial Q-wave and non-Q-wave Myocardial Infarction: A Multi –Hospital ,Community –Wide Perspective. J Am Coll Cardiol 2001; 37: 1571–1580.

  9. Ryan TJ, Antman EM, Brooks NH, Califf RM, Hillis DL, Hiratzka LF, et al: ACC/AHA Guidelines for the management of patients with acute myocardial infarction: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Management of Acute Myocardial Infarction). 1999 update. Localizable en: http://www.acc.org/clinical/guidelines/ami.html

  10. Braunwald E, Antman EM, Beasley JW, Califf RM, Cheitlin MD, Hochman JS, et al: ACC/ AHA Guidelines for the managements of patients with unstable angina and non-ST segment elevation MI: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Management of Patients With Unstable Angina). J Am Coll Cardiol 2000; 36: 970–1062.

  11. Wu AH, Apple FS, Gibler WB, Jesse RL, Warshaw MM, Valdes RJ: National Academy of Clinical Biochemistry Standards of Laboratory Practice recommendations for the use of cardiac markers in coronary artery diseases. Clin Chem 1999; 45: 1104-1121.

  12. Braunwald E: Unstable angina: an etiologic approach to management (Editorial). Circulation 1998; 98: 2219-2222.

  13. Braunwald E: Unstable angina classification. Circulation 1989; 80: 410-414.

  14. Campeau L: Grading of angina pectoris (Letter). Circulation 1976; 54: 522-533.

  15. PURSUIT Trial Investigators: Inhibition of platelet glycoprotein IIb/IIIa with eptifibatide in patients with acute coronary syndromes. The PURSUIT Trial Investigators Platelet Glycoprotein IIb/IIIa in Unstable Angina: Receptor Suppression Using Integrilin Therapy. N Engl J Med 1998; 339: 436-443.

  16. Selker HP, Beshansky JR, Griffith JL: Use of the acute cardiac ischemia time-insensitive predictive instrument (ACI-TIPI) to assist with triage of patients with chest pain or other symptoms suggestive of acute cardiac ischemia: a multicenter, controlled clinical trial. Ann Intern Med 1998; 129: 845-855.

  17. Ghali JK, Cooper RS, Kowatly I, Liao Y: Delay between onset of chest pain and arrival to the coronary care unit among minority and disadvantaged patients. J Natl Med Assoc 1993; 85: 180-184.

  18. Altman DG: Practical statistics for medical research. London: Chapman and Hall; 1991.

  19. Hargarten K, Chapman PD, Stueven HA: Prehospital prophylactic lidocaine does not favorably affect outcome in patients with chest pain. Ann Emerg Med 1990; 19: 1274-1279.

  20. Eagle KA, Goodman SG, Avezum A for the GRACE investigators: Practice variation and missed opportunities for reperfusion in ST-segment-elevation myocardial infarction: findings from the Global Registry of Acute Coronary Events (GRACE). Lancet 2002; 359: 373-377.

  21. Newby LK, Califf RM, Guerci A, Weaver DW, Col J, Horgan JH, et al: Early discharge in the thrombolytic era: an analysis of criteria for uncomplicated infarction from the Global Utilization of Streptokinase and t-PA for Occluded Coronary Arteries (GUSTO) trial. J Am Coll Cardiol 1996; 27: 625-632.

  22. Maynard C, Weaver WD, Lambrew C, Bowlby LJ, Rogers WJ, Rubison RM, for participants in the National Registry of Myocardial Infarction: Factors influencing the time to administration of thrombolytic therapy with recombinant tissue plasminogen activator (data from the National Registry of Myocardial Infarction). Am J Cardiol 1995; 76: 548-552.

  23. Weaver WD, Cerqueira M, Hallstrom AP: Prehospital-initiated vs hospital-initiated thrombolytic therapy: the Myocardial Infarction Triage and Intervention Trial. JAMA 1993; 270: 1211-1216.

  24. Pope JH, Ruthazer R, Beshansky JR, Griffith JL, Selker HP: Clinical features of emergency department patients presenting with symptoms suggestive of acute cardiac ischemia a multicenter study. J Thromb Thrombolysis 1998; 6: 63-74.

  25. Theroux P, Fuster V: Acute coronary syndromes: unstable angina and non–Q-wave myocardial infarction. Circulation 1998; 97: 1195-1206.

  26. Savonitto S, Ardissino D, Granger C, Morando G, Prando MD, Mafrici A, et al: Prognostic value of the admission electrocardiogram in acute coronary syndromes. JAMA 1999; 281: 707–713.

  27. Cannon CP, Thompson B, McCabe C, Mueller HS, Kirshenbaum JM, Herson S, et al: Predictors of non-Q-wave acute myocardial infarction in patients with acute ischemic syndromes: an analysis from the thrombolysis in myocardial ischemia (TIMI ) III trials. Am J Cardiol 1995; 75: 977-981.

  28. Antman EM: Troponin Measurements in Ischemic Heart Disease: More Than Just a Black and White Picture. J Am Coll Cardiol 2001; 38: 987-990.

  29. Antman EM, Cohen M, Bernink PJLM, McCabe CH, Horacek T, Papuchis G, et al: The TIMI risk score for unstable angina – non ST-elevation MI: a method for prognostication and therapeutic decision-making. JAMA 2000; 284: 835- 842.

  30. SHEP Cooperative Research Group: Prevention of stroke by anti-hypertensive drug treatment in older persons with isolated systolic hypertension: final results of the Systolic Hypertension in the Elderly Program (SHEP). JAMA 1991; 265: 3255-3264.

  31. Cohen M, Stinnett S, Weatherley B, Gurfinkel EP, Fromell G, Goodman SG, et al: Predictors of recurrent ischemic events and death in unstable coronary artery disease after treatment with combination antithrombotic therapy. Am Heart J 2000; 139: 962-970.

  32. Chaitman BR, Bourassa MG, Davis K, Rogers WJ, Tyras DH, Berger R, et al: Angiographic prevalence of high-risk coronary artery disease in patient subsets (CASS). Circulation 1981; 64: 360-367.

  33. Pryor DB, Harrell FEJ, Lee KL, Califf RM, Rosati RA: Estimating the likelihood of significant coronary artery disease. Am J Med 1983; 75: 771-780.

  34. Pryor DB, Shaw L, McCants CB, Lee KL, Mark DB, Harrell FE, et al: Value of the history and physical in identifying patients at increased risk for coronary artery disease. Ann Intern Med 1993; 118: 81-90.

  35. Gibbons RJ, Chatterjee K, Daley J, Douglas JS, Fihn SD, Gardin JM, et al: ACC/AHA/ACP-ASIM guidelines for the management of patients with chronic stable angina. J Am Coll Cardiol 1999; 33: 2092-2197.

  36. Lee TH, Cook EF, Weisberg M, Sargent RK, Wilson C, Goldman L: Acute chest pain in the emergency room: identification and examination of low-risk patients. Arch Intern Med 1985; 145: 65-69.

  37. Pozen MW, D’Agostino RB, Selker HP, Sytkowski PA, Hood WBJ: A predictive instrument to improve coronary-care-unit admission practices in acute ischemic heart disease: a prospective multicenter clinical trial. N Engl J Med 1984; 310: 1273-1278.

  38. Selker HP, Griffith JL, D’Agostino RB: A tool for judging coronary care unit admission appropriateness, valid for both real-time and retrospective use: a time-insensitive predictive instrument (TIPI) for acute cardiac ischemia a multicenter study [erratum appears in Med Care 1992; 30: 188]. Med Care 1991; 29: 610-627.

  39. Brieger DB, Mak KH, White HD, Kleiman NS, Miller DP, Vahanian A, et al: Benefit of early sustained reperfusion in patients with prior myocardial infarction (the GUSTO-I trial). Global Utilization of Streptokinase and TPA for Occluded Arteries. Am J Cardiol 1998; 81: 282-287.

  40. Hochman JS, Tamis JE, Thompson TD, Weaver D, White HD, Van de Werf F, et al: for the Global Use of Strategies to Open Occluded Coronary Arteries in Acute Coronary Syndromes IIb Investigators. Sex, clinical presentation, and outcome in patients with acute coronary syndromes. N Engl J Med 1999; 341: 226-232.

  41. Hochman JS, McCabe CH, Stone PH, Becker RC, Cannon CP, DeFeo-Fraulini T, et al. for the TIMI Investigators: Thrombolysis In Myocardial Infarction. Outcome and profile of women and men presenting with acute coronary syndromes: a report from TIMI IIIB. J Am Coll Cardiol 1997; 30: 141-148.

  42. Juárez UH, Lasses LA, Martín RP, Luna JG, López MCR, Chuquiure EV, et al: Utilidad de la determinación cualitativa rápida de troponina T, fracción MB de creatina fosfocinasa y mioglobina en los síndromes isquémicos coronarios agudos. Arch Inst Cardiol Méx 1998; 68: 473–481.

  43. Ross AM, MolhoeK P, Lundergan C: Randomized comparison of enoxaparin, a low-molecular –weight heparin, with unfarctionated heparin adjuntive to recombinant tissue plasminogen activator thrombolysis and aspirin: second trial of heparin and aspirin reperfusion therapy (HEART II). Circulation 2001; 22: 13-22.

  44. Antman EM, Louwerenburg HW, Baars HF, Wesdorp JCL, Hamer B, Bassand J-P, et al. for the ENTIRE – TIMI 23 Investigators: Enoxaparin as adjunctive antithrombin therapy for ST-Elevation myocardial infarction: Results of the ENTIRE – Thrombolysis in Myocardial Infarction (TIMI ) 23 trial. Circulation 2002; 105: 1642–1649.

  45. Holmes DRJ, White HD, Pieper F, Ellis SG, Califf RM, Topol EJ: Effect of age on outcome with primary angioplasty versus thrombolysis. J Am Coll Cardiol 1999; 33: 412-419.

  46. White HD, Barbash GI, Califf RM, Simes JR, Granger CB, Weaver D, et al: Age and outcome with contemporary thrombolytic therapy: results from the GUSTO-I trial. Global Utilization of Streptokinase and TPA for Occluded coronary arteries trial. Circulation 1996; 94: 1826-1833.

  47. Mak KH, Moliterno DJ, Granger CB, Miller DP, White HD, Wilcox RG, et al. for the GUSTO-I Investigators: Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Coronary Arteries. Influence of diabetes mellitus on clinical outcome in the thrombolytic era of acute myocardial infarction. J Am Coll Cardiol 1997; 30: 171-179.

  48. Jerjes–Sánchez C, Arriaga–Nava R, Martínez–Enriquez: Accelerated versus standard streptokinase infusion in acute myocardial infarction. Chest 1996; 110: 107S.

  49. Martínez–Sánchez C, Domínguez JL, Aguirre SJ, Carrillo J, Chuquiure EV, Franco J, et al: Tratamiento del infarto agudo al miocardio con rt-PA en 60 minutos . Estudio Cooperativo. Arch Inst Cardiol Méx1997; 67: 126-131.

  50. Jerjes–Sánchez C, Garza-Ruíz A, Gutierrez-Fajardo P: Trombólisis farmacológica en el infarto agudo del miocardio: lecciones aprendidas después del ISSIS –2 y GUSTO I. (Parte I). Arch Inst Cardiol Méx1999; 69: 478-487.

  51. Jerjes –Sánchez C, Garza Ruíz A, Gutierrez-Fajardo P: Trombólisis farmacológica en el infarto agudo del miocardio: lecciones aprendidas después del ISSIS –2 y GUSTO I. (Parte II). Arch Inst Cardiol Méx 1999; 69: 570-579.

  52. Juárez –Herrera U, Lasses LA, López MC, Chuquiure E, Gónzalez PH, Carrillo CJ, et al: Resultados del enfermo con infarto agudo del miocardio con terapia trombolítica. Experiencia en 473 enfermos de la unidad coronaria del Instituto Nacional de Cardiología “Ignacio Chávez”. Arch Inst Cardiol Méx1998; 68: 411-420.

  53. Carrillo CJ, Chuquiure E, Martínez –Sánchez C, Gónzalez PH, Jáuregui L, Juárez –Herrera U, et al: Análisis de la permeabilidad de la arteria responsable del infarto miocárdico agudo. Arch Inst Cardiol Méx 1997; 67: 186-194 .

  54. Hochman JS, Sleeper LA, Godfrey E, McKinlay SM, Sanborn T, Col J, et al. for the SHOCK Trial Study Group.: Should we emergently revascularize Occluded Coronaries for Cardiogenic ShocK: an international randomized trial of emergency PTCA/CABG-trial design. Am Heart J 1999; 137: 313–321.

  55. Holmes DR Jr, Berger BP, Hochman JS, Granger CB, Thompson TD, Califf RM, et al: Cardiogenic shock in patients with acute ischemic syndromes with and without ST-segment elevation. Circulation 1999; 100: 2067–2073.

  56. Rouan GW, Lee TH, Cook EF, Brand DA, Weisberg MC, Goldman L: Clinical characteristics and outcome of acute myocardial infarction in patients with initially normal or nonspecific electrocardiograms (a report from the Multicenter Chest Pain Study). Am J Cardiol 1989; 64: 1087-1092.

  57. Zaacks SM, Liebson PR, Calvin JE, Parrillo JE, Klein LW: Unstable angina and non–Q wave myocardial infarction: does the clinical diagnosis have therapeutic implications? J Am Coll Cardiol 1999; 33: 107-118.

  58. Lee TH, Cook EF, Weisberg MC, Rouan GW, Brand DA, Goldman L: Impact of the availability of a prior electrocardiogram on the triage of the patient with acute chest pain. J Gen Intern Med 1990; 5: 381-388.

  59. Fesmire FM, Percy RF, Wears RL: Diagnostic and prognostic importance of comparing the initial to the previous electrocardiogram in patients admitted for suspected acute myocardial infarction. South Med J 1991; 84: 841-6.

  60. Adams JE, Abendschein DR, Jaffe AS: Biochemical markers of myocardial injury: is MB creatine kinase the choice for the 1990s? Circulation 1993; 88: 750-763.

  61. Gomez-Villalobos M, Vargas-Barrón J, Romero-Cárdenas A, Rijlaarsdam M, Keirns C, Lupi-Herrera E, et al: Right Atrial and Ventricular Infarction: Evaluation with Transesophageal Echocardiography. Echocardiography 1995; 12: 129-137.

  62. Battler A, Slutsky R, Karliner J, Froelicher V, Ashburn W, Ross J Jr: Left ventricular ejection fraction and first third ejection fraction early after myocardial infarction: value for predicting mortality and morbidity. Am J Cardiol 1980; 45: 197–202.

  63. Zornoff LAM, Skali H, Pfeffer MA, St. John SM, Rouleau JL, Lamas GA, et al. for the SAVE Investigators: Right ventricular dysfunction and risk of heart failure and mortality after myocardial infarction. J Am Coll Cardiol 2002; 39: 1450–1455.

  64. Lupi –Herrera E, Lasses LA, Cosio-Aranda J, Chuquiure-Valenzuela E, Martínez –Sánchez C, Ortíz P, et al: Acute right ventricular infarction: clinical spectrum, results of reperfusion therapy and short-term prognosis. Coron Artery Dis 2002; 13: 57-64.

  65. Boerma E, Harrington RA, Moliterno DJ, White H, Teroux P, Van de Werf F, et al: Platelet glycoprotein IIb/IIIa inhibitors in acute coronary syndromes: a meta-anlysis of all major randomized trials. Lancet 2002; 359: 189–198.

  66. Bertrand ME, Simmons ML, Fox KAA: Management of acute coronary syndromes: acute coronary syndromes without persistent ST segment elevation: recommendation of the Task Force of the European Society of Cardiology. Eur Heart J 2000; 21: 1406–1432.

  67. Falk E: Plaque rupture with severe pre-existing stenosis precipitating coronary thrombosis: characteristics of coronary atherosclerotic plaquesunderlying fatal occlusive thrombi. Br Heart J 1983; 50: 127–134.

  68. Davies MJ, Thomas A: Thrombosis and acute coronary-artery lesions in sudden cardiac ischemic death. N Engl J Med 1984; 310: 1137–1140.

  69. Falk E, Shah PK, Fuster V: Coronary plaque disruption. Circulation 1995; 92: 657–671.

  70. Libby P: Molecular basis of the acute coronary syndromes. Circulation 1995; 91: 2844–2850.

  71. Davies MJ: A macro and micro view of coronary vascular insult in ischemic heart disease. Circulation 1990; 82 (Suppl II): II-38–II-46.

  72. Goldstein JA, Demetriou D, Grines CL, Pica M, Shoukfeh M, O´Neill WW: Multiple complex coronary plaques in patients with acute myocardial infarction. N Engl J Med 2000; 343: 915–922.

  73. Asakura M, Ueda Y, Yamaguchi O, Adachi T, Hirayama A, Hori M, et al: Extensive development of vulnerable plaques as a pan-coronary process in patients with myocardial infarction: an angioscopic study. J Am Coll Cardiol 2001; 37: 1284–1288.




2020     |     www.medigraphic.com