Acute Myocardial Infarction with Persistent ST-Segment Elevation. SCAR (Acute Coronary Syndromes in Argentina) Multicenter Registry from the Argentine Society of Cardiology

pp 259-267

Abstract

Introduction: Acute coronary syndrome registries made by the Argentine Society of Cardiology provide current and comparative information on their evolution, whose analysis allows to know the mortality rate and the different regional treatment patterns, and to evaluate the relationship between outcomes and demographic variables, clinical characteristics and therapy applied in “real life”.
Objectives: To analyze the clinical, therapeutic and outcome characteristics of ST segment elevation acute myocardial infarction (STEMI) included in a multicenter registry conducted by the Argentine Society of Cardiology in 2011.
Methods: Patients diagnosed with STEMI included in the multicenter SCAR (Acute Coronary Syndromes in ARgentina) registry were
analyzed. Data from centers that participated in the 2005 and 2011 registries were compared.
Results: The study included 476 patients. Twenty-five percent of patients were women, mean age was 61 ± 12.3 years, and 70% received reperfusion therapy: 20% (n = 92) with thrombolytics and 50% (n = 238) with primary angioplasty. In-hospital mortality rate due to STEMI was 8%. Independent predictors of death were age over 70 years (OR 2, 95 % CI 1.2-3.3, p = 0.003), not having received reperfusion therapy (OR 1.72, 95 % CI 1.1 - 2.0, p = 0.01) and cardiogenic shock (OR 37, 95 % CI 12-117, p < 0.0001). Comparison of the same centers showed that in 2011 the number of cases that did not receive reperfusion therapy was reduced by 30%, with increased use of primary angioplasty [OR 3.7 (95 % CI 1.6-4, p < 0.001)]. A reduction of in-hospital mortality [OR 0.40 (95 % CI 0.23-0.83, p = 0.01)] was also identified.
Conclusions: Seventy percent of patients with STEMI included in the SCAR registry received reperfusion therapy, while mortality rate
was 8%. Compared with 2005, an increase of primary angioplasty and decreased in-hospital mortality was observed, among other findings