Revista chilena de cardiología
On-line version ISSN 0718-8560
MARTINEZ S, Alejandro et al. Mortality in Myocardial Infarction in Chile: a comparison from the angioplasty and thrombolysis registries. Rev Chil Cardiol [online]. 2010, vol.29, n.1, pp. 29-36. ISSN 0718-8560. doi: 10.4067/S0718-85602010000100003.
Background: From 2005, thrombolysis has been made available as a public health policy to treat acute myocardial infarction (AMI) in Chile. A comparison with results obtained locally with primary PTCA is relevant Aim: to compare early and late mortality in AMI between thrombolysis and PTCA treatments and to determine risk factors associated to mortality Methods: Data from national registries of PTCA (RENAC) and trombolysis (GEMI) of patients treated from 2003 through 2004 were analyzed. Early (<30day) and late (12 and 24 months) mortality was compared between groups. Logistic regression analysis was used to identify independent risk factors for mortality. Results: 857 patients received thrombolysis and 700 were treated by PTCA. Age, sex, prevalence of diabetes, hypertension, dyslipidemia and prior AMI were similar in both groups. PTCA was associated to lower mortality rates compared to thrombolysis (crude HR 0.65, 95% C. I. 0.49-0.86, p= 0.03). Early, 12month and 24month mortality rates for thrombolysis and PTCA treated patients were 10.6 vs. 6.3%, , 15.3 vs. 10.6% and 21.1 vs. 11.7%, respectively (p<0.01). Increased age, female gender and presence of diabetes were independently associated to mortality, overall. Conclusion: Primary PTCA was associated to lower early and late mortality rates compared to thrombolysis in Chilean registry data.
Keywords : Myocardial Infarction; angioplasty; thrombolysis.