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Lopez-Rojas LM, Paredes Paucar CP, Rojas De La Cuba P, Yábar Galindo WG, Martos Salcedo JO, Custodio-Sánchez P. [Reply yo the letter to the editor : "Keeping an eye on the pharmacoinvasive strategy"]. ARCHIVOS PERUANOS DE CARDIOLOGIA Y CIRUGIA CARDIOVASCULAR 2024; 5:e368. [PMID: 39015188 PMCID: PMC11247967 DOI: 10.47487/apcyccv.v5i2.368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2024] [Accepted: 04/15/2024] [Indexed: 07/18/2024]
Affiliation(s)
- L. Marco Lopez-Rojas
- Hospital Nacional Alberto Sabogal Sologuren - EsSalud. Lima, Perú.Hospital Nacional Alberto Sabogal Sologuren - EsSaludLimaPerú
| | - Cynthia Paola Paredes Paucar
- Hospital Germans Trias i Pujol, Unidad de Insuficiencia Cardiaca. Barcelona, España.Hospital Germans Trias i PujolUnidad de Insuficiencia CardiacaBarcelonaEspaña
| | - Paol Rojas De La Cuba
- Hospital Nacional Guillermo Almenara Irigoyen-EsSalud. Lima, Perú.Hospital Nacional Guillermo Almenara Irigoyen-EsSaludLimaPerú
| | - W. Germán Yábar Galindo
- Hospital Nacional Guillermo Almenara Irigoyen-EsSalud. Lima, Perú.Hospital Nacional Guillermo Almenara Irigoyen-EsSaludLimaPerú
| | - Jorge Orlando Martos Salcedo
- Hospital Regional Docente de Cajamarca-MINSA. Servicio de Cardiología. Cajamarca, Perú.Hospital Regional Docente de Cajamarca-MINSAServicio de CardiologíaCajamarcaPerú
| | - Piero Custodio-Sánchez
- Hospital Nacional Almanzor Aguinaga Asenjo - EsSalud. Unidad de cardiología intervencionista. Chiclayo, Perú.Hospital Nacional Almanzor Aguinaga Asenjo - EsSaludUnidad de cardiología intervencionistaChiclayoPerú
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Costabel JP, Quintana M, Perea J, Lamelas P, Candiello A, Sanhueza P, Arias-Mendoza A, Saavedra I, Rivera-Toquica A, de Castro ML, Álvarez-Gaviria M, Belardi J, Cequier Á, Sosa-Liprandi Á, Villarreal R. [Position statement for improvement in reperfusion of ST-elevation myocardial infarction in Latin America]. ARCHIVOS DE CARDIOLOGIA DE MEXICO 2024; 94:208-218. [PMID: 38227853 PMCID: PMC11160544 DOI: 10.24875/acm.23000045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Accepted: 09/07/2023] [Indexed: 01/18/2024] Open
Abstract
The treatment of ST-segment elevation myocardial infarction has barriers depending on the geographic region. Primary coronary angioplasty is the treatment of choice, if it is performed on time and by experienced operators. However, when it is not available, the administration of fibrinolysis and referral for rescue angioplasty, in case of negative reperfusion, is the best strategy. In the same way, coronary angioplasty, as part of a pharmacoinvasive strategy, is the best alternative when there is positive reperfusion. The development of infarct treatment networks increases the number of patients reperfused within the recommended times and improves outcomes. In Latin America, national myocardial infarction treatment programs should focus on improving outcomes, and long-term success depends on working toward defined goals and enhancing functionality, therefore programs should develop capacity to measure their performance. The following document discusses all of these alternatives and suggests opportunities for improvement.
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Affiliation(s)
- Juan P. Costabel
- Unidad Coronaria, Instituto Cardiovascular de Buenos Aires, Buenos Aires, Argentina
| | - Miguel Quintana
- Unidad Coronaria, Instituto Cardiovascular del Sanatorio Migone, Asunción, Paraguay
| | - Joaquín Perea
- Unidad Coronaria, Sanatorio Güemes, Buenos Aires, Argentina
| | - Pablo Lamelas
- Departamento de Cardiología Intervencionista, Instituto Cardiovascular de Buenos Aires, Buenos Aires, Argentina
| | - Alfonsina Candiello
- Departamento de Cardiología Intervencionista, Instituto Cardiovascular de Buenos Aires, Buenos Aires, Argentina
| | | | - Alexandra Arias-Mendoza
- Unidad Coronaria, Instituto Nacional de Cardiología Ignacio Chávez, Ciudad de México, México
| | - Iván Saavedra
- Unidad Coronaria, Hospital Biocor, Nova Lima, Brasil
| | | | | | | | - Jorge Belardi
- Departamento de Cardiología Intervencionista, Instituto Cardiovascular de Buenos Aires, Buenos Aires, Argentina
| | - Ángel Cequier
- Unidad Coronaria, Instituto de Investigación Biomédica de España, Barcelona, España
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Custodio-Sánchez P, Miranda-Noé D, López-Rojas LM, Paredes Paucar CP, Yábar Galindo WG, Rojas De La Cuba P, Martos Salcedo JO, Chacón-Diaz M. [Proposal for initial management of uncomplicated ST elevation myocardial infarction in centers without percutaneous coronary intervention capacity in Peru]. ARCHIVOS PERUANOS DE CARDIOLOGIA Y CIRUGIA CARDIOVASCULAR 2023; 4:164-183. [PMID: 38298415 PMCID: PMC10824752 DOI: 10.47487/apcyccv.v4i4.335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 12/18/2023] [Indexed: 02/02/2024]
Abstract
ST-segment elevation myocardial infarction (STEMI) is a clinical entity whose adequate treatment will depend on its prompt recognition, accurate diagnosis, and management in reperfusion networks. The first contact with these patients is generally done in centers without reperfusion capacity, attended by non-cardiologist doctors, and in centers far from hospitals with greater resolution capacity, something that is well known in our country. This manuscript proposes a strategy for the diagnosis and treatment of STEMI in centers without percutaneous coronary intervention capacity of the public health system in Peru, emphasizing not losing sight of electrocardiographic patterns compatible with coronary artery occlusion, adequate fibrinolysis and management of its complications, the treatment of infarction in special populations and highlighting the importance of the pharmacoinvasive strategy as the main form of reperfusion treatment in our country.
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Affiliation(s)
- Piero Custodio-Sánchez
- Unidad de Cardiología Intervencionista, Hospital Nacional Almanzor Aguinaga Asenjo, Chiclayo, Perú.Unidad de Cardiología IntervencionistaHospital Nacional Almanzor Aguinaga AsenjoChiclayoPerú
| | - David Miranda-Noé
- Servicio de Cardiología Clínica. Instituto Nacional Cardiovascular INCOR, Lima, Perú.Servicio de Cardiología ClínicaInstituto Nacional Cardiovascular INCORLimaPerú
| | - L. Marco López-Rojas
- Hospital Nacional Hipólito Unanue, Lima, Perú.Hospital Nacional Hipólito UnanueLimaPerú
| | - Cynthia Paola Paredes Paucar
- Unidad de insuficiencia cardiaca, Hospital Germans Trias i Pujol, Barcelona, España.Unidad de insuficiencia cardiacaHospital Germans Trias i PujolBarcelonaEspaña
| | - W. Germán Yábar Galindo
- Hospital Nacional Guillermo Almenara Irigoyen, Lima, Perú.Hospital Nacional Guillermo Almenara IrigoyenLimaPerú
| | - Paol Rojas De La Cuba
- Hospital Nacional Guillermo Almenara Irigoyen, Lima, Perú.Hospital Nacional Guillermo Almenara IrigoyenLimaPerú
| | - Jorge Orlando Martos Salcedo
- Servicio de Cardiología. Hospital Regional Docente de Cajamarca, Cajamarca, Perú.Servicio de CardiologíaHospital Regional Docente de CajamarcaCajamarcaPerú
| | - Manuel Chacón-Diaz
- Unidad Cardiovascular. Clínica Delgado AUNA, Lima, Perú.Unidad CardiovascularClínica Delgado AUNALimaPerú
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