| Abstract | dc.description.abstract | Primary angioplasty is considered the best reperfusion therapy
in the treatment of ST-segment elevation myocardial infarction (STEMI). However, thrombolysis is the
reperfusion method most commonly used, due to its wide availability, reduced costs and ease of
administration. Aim: To compare in-hospital mortality in STEMI patients according to reperfusion
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% (7.5% in men and 16.7% in women, p <0.001). Mortality in patients treated with thrombolytics,
was 10.2% (7.6% 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 reperfusion, 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 | en_US |
