Hameau D René, Blacud M Ricardo, Fanta A Mario, Alvarado L Cristobal, Hameau D Cristobal, Olmos C Alfonso, Pérez P Osvaldo
Unidad de Medicina Cardiovascular Integrada, Hospital Las Higueras, Talcahuano, Chile.
Facultad de Medicina, Universidad de Concepción, Concepción, Chile.
Rev Med Chil. 2022 Dec;150(12):1619-1624. doi: 10.4067/s0034-98872022001201619.
In those patients who do not have timely access to primary angioplasty, the pharmaco-invasive approach, that is, the use of thrombolysis as a bridging measure prior to the coronary angiography, is a safe alternative.
To describe the features of patients with an acute ST-elevation myocardial infarction (STEMI) treated with a pharmaco-invasive strategy.
Descriptive observational study of 144 patients with mean age of 46 years with STEMI who received a dose of thrombolytic prior to their referral for primary angioplasty at a public hospital between 2018 and 2021.
There were no differences the clinical presentation according to the Killip score at admission between thrombolyzed and non-thrombolyzed patients (p = ns). Fifty-three percent of non-thrombolyzed patients were admitted with an occluded vessel (TIMI 0) compared with 27% of thrombolyzed patients (p < 0.001). The thrombolyzed group required significantly less use of thromboaspiration (3.5 and 8.4% respectively; p = 0.014). Despite this, 91 and 92% of non-thrombolyzed and thrombolyzed patients achieved a post-angioplasty TIMI 3 flow. Long-term survival was 91 and 86% in thrombolyzed and non-thrombolyzed patients, respectively (p = ns).
The pharmaco-invasive strategy is a safe alternative when compared to primary angioplasty in centers that don't have timely access to Interventional Cardiology.
在那些无法及时进行直接血管成形术的患者中，药物介入治疗方法，即在冠状动脉造影之前使用溶栓作为桥接措施，是一种安全的替代方法。
描述采用药物介入策略治疗的急性ST段抬高型心肌梗死（STEMI）患者的特征。
对2018年至2021年期间在一家公立医院转诊接受直接血管成形术之前接受一剂溶栓治疗的144例平均年龄为46岁的STEMI患者进行描述性观察研究。
溶栓患者和未溶栓患者入院时根据Killip评分的临床表现无差异（p =无统计学意义）。53%的未溶栓患者入院时血管闭塞（TIMI 0），而溶栓患者为27%（p < 0.001）。溶栓组血栓抽吸的使用明显较少（分别为3.5%和8.4%；p = 0.014）。尽管如此，91%的未溶栓患者和92%的溶栓患者血管成形术后达到TIMI 3级血流。溶栓患者和未溶栓患者的长期生存率分别为91%和86%（p =无统计学意义）。
在无法及时获得介入心脏病学治疗的中心，与直接血管成形术相比，药物介入策略是一种安全的替代方法。
