Browsing by Author "Campos, Pabla"

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    In-hospital mortality after ST-segment elevation myocardial infarction according to reperfusion therapy
    (2008) Prieto, Juan Carlos; Sanhueza, Consuelo; Martinez, Nicolas; Nazzala, Carolina; Corbalan, Ramon; Cavada, Gabriel; Lanas, Fernando; Bartolucci, Jorge; Campos, Pabla
    Background: Primary angioplasty is considered the best repefusion therapy in The treatment of ST-segment elevation))myocardial infarction (STEMI). However, thrombolysis the reperfusion, method most commonly used, due to its wide availability reduced costs and case of administration. Aim To compare in-hospital mortality, in STEMI patients according to repefusion 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 reperfusion procedure. In-hospital 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% (75% in men and 16.7% in women, p < 0.001). Mortality in patients treated with thrombolytics, was 10.2% (76% 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 reperfusion, 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 repefusion, was associated with a reduced mortality only in men. The use of thrombolytics in women was associated with a higher mortality. Conclusions: Primary angioplasty was the reperfusion 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
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    Resultados Chilenos del registro internacional de factores de riesgo y tratamiento de angina inestable e infarto al miocardio sin supradesnivel del segmento ST: ACCORD (ACute CORonary syndrome Descriptive study)
    (SOC MEDICA SANTIAGO, 2011) Stockins, Benjamin; Albornoz, Francisco; Martinez, Dario; Campos, Pabla; Gajardo, Jorge; Lamich, Ruben; Manriquez, Leopoldo; Perez, Victor; Rojo, Pamela; Sepúlveda Varela, Pablo Andrés; Gabriela Pumarino, M.; Corbalan, Ramon
    Background: Guidelines for the management of unstable angina (UA) and non ST elevation myocardial infarction (NSTEMI) have been issued, however current practices are unknown in Chile. Aim: To evaluate in a prospective cohort of NSTEMI patients the current practices, treatments and risk factors. Material and Methods: One year prospective International non interventional registry, conducted in Chile between January 2005 and November 2006. Results: Two hundred thirty three Chilean NSTEMI patients were enrolled. Mortality was 5.5% at the end of the follow-up. Mean age was 61.6 years, and 30.6% were female. Most of the patients had at least one risk factor (98%): hypertension (84%), previous myocardial infarction (33%), dyslipidemia (54%), diabetes (33%), current smoking (30%). Main procedures during the hospitalization were coronary angiogram (67%), angioplasty (33%; 88% with stent) and coronary bypass surgery (7%). During procedures, 31% of patients received clopidogrel, and 4.2% glycoprotein IIb/IIIa antagonists. Medical management was selected for 60% of patients. In comparison to men, women received less interventional procedures despite having more risk factors. Treatments prescribed at discharge were aspirin (97%), clopidogrel (49%), beta blockers (78%), diuretics (21%), lipid lowering agents (78%), oral hypoglycemic agents (13%) and insulin (9%). At the end of the 1-year follow-up, treatments were aspirin (84%), beta blockers (72%), diuretics (19%), and dual antiplatelet therapy with clopidogrel (16%). Conclusions: A high prevalence of multiple risk factors for cardiovascular disease in Chilean patients with NSTEMI was observed. More aggressive primary and secondary preventive measures are urgently needed. Use of therapies proposed in the guidelines is high, but dual antiplatelet therapy is less than 50% at discharge and decreases during the one year-follow-up. (Rev Med Chile 2011; 139: 19-26).