Mortality Patterns in ST-Segment Elevation Myocardial Infarction Over 10 Years in Argentina. ARGEN-IAM-ST Registry

pp. 5-11

Abstract

Background: Acute myocardial infarction (AMI) is the leading cause of preventable death in Argentina and in most developing countries. Publications evaluating cardiovascular mortality have shown a downward trend over the last 20 years, attributable to significant advancements in care.  

Objective: The aim of this study is to evaluate mortality of ST-segment elevation MI (STEMI) in Argentina, time from symptom onset to presentation, and time to reperfusion over a 10-year period. Methods: Cases registered in the ARGEN-IAM-ST registry with a date of chest pain onset between January 1, 2015, and December 31, 2024, were analyzed. The characteristics of the population, times to presentation, in-hospital mortality, and complications during hospitalization due to STEMI were explored.

Results: A total of 7690 cases were analyzed from 209 institutions. Mean age was 61.1 ± 12 years, and 79% were male. The median time from the onset of pain to presentation was 120 minutes (interquartile range, IQR, 59-243), door-to-needle time was 55 minutes (IQR 30-120), total ischemic time for fibrinolytic therapy was 180 minutes (IQR 108-300), door-to-balloon time was 79 minutes (IQR 45-137), and total ischemic time for percutaneous coronary intervention was 315 minutes (IQR 190-607). These values did not present significant variations when compared individually over time. In-hospital mortality was 8.6%, over 10 years with no statistically significant variations when comparing annual periods (p = 0.927), despite reperfusion rate was > 90% in 8 of the 10 years evaluated.

Conclusion: Over the past 10 years, the ARGEN-IAM-ST registry showed absence of significant changes in in-hospital mortality, time to presentation and time to treatment. It is necessary to take specific actions to change the reality of STEMI in Argentina.