National survey of st-segment elevation acute myocardial infarction in argentina (argen-iam-st)

Background: ST-segment elevation acute myocardial infarction (STEMI) is one of the most challenging pathologies for the health system; therefore, it is necessary to have a registry with suitably accurate information to adopt public policies and guidelines adjusted to national needs. The Argentine Society of Cardiology (SAC) and the Argentine Federation of Cardiology (FAC) are carrying out a national registry (ARGEN-IAM-ST) that aims to comprise the “universe” of STEMI treatment. Objective: The purpose of this study was to evaluate, as broadly as possible, clinical aspects, delays, treatment strategies and outcomes, as well as eventual barriers that need improvement in STEMI care. Methods: The study included 1,759 patients in 247 centers throughout the country between March and December 2015. Results: Among all patients, 83.5% received reperfusion treatment, and in 78.3% of cases, this was performed by primary angioplasty. Thirty-seven per cent of patients were admitted from another institution, but only 16% of them received fibrinolytic therapy prior to referral. Door-to-needle time was ≤30 minutes in only 25% of patients receiving fibrinolytic agents and door-to-balloon time was ≤90 minutes in 47.7% of patients treated with angioplasty. In-hospital mortality was 8.8%. Conclusions: These data allow delineating a map of acute myocardial infarction in Argentina. Delays in treatment are important and there are aspects to correct. These data suggest the need to implement corrective strategies, such as the application of medical education programs, supportive health policies, considering regional characteristics and on-site cost/benefit of reperfusion strategies, which might help to shorten time to reperfusion, both for thrombolytic therapy as for primary angioplasty. Introducción: El infarto agudo de miocardio con elevación del segmento ST (IAMCEST) es una de las patologías que más desafíos le impone al sistema de salud, por lo que es necesario contar con un registro con la suficiente solidez de información que permita adoptar políticas públicas y guías ajustadas a las necesidades nacionales. La Sociedad Argentina de Cardiología (SAC) y la Federación Argentina de Cardiología (FAC) se encuentran llevando a cabo un registro nacional (ARGEN-IAM-ST) que intenta llegar al “universo” de la atención del IAMCEST. Objetivo: Relevar a nivel nacional, en la forma más amplia posible, aspectos de la clínica, demoras y esquemas de tratamiento y resultados, así como las even