Terapia de reperfusión en infarto agudo al miocardio. Comparación entre trombolisis endovenosa y angioplastía coronaria

Abstract

Background: Primary angioplasty is superior to intravenous thrombolysis as reperfusion therapy for acute myocardial infarction. Aim: To compare the results of available reperfusion strategies for initial management of acute myocardial infarction during hospitalization and 5 years follow up. Patients and Methods: Historical cohort study from a prospective registry of patients admitted with acute myocardial infarction to our center. Patients treated with primary angioplasty were identifi ed and were then matched by age, sex and date of event with patients treated with thrombolysis. The clinical outcomes were compared including hospitalization and 5-years follow-up. Results: From March 1993 to August 2001, 98 patients were treated with primary angioplasty and matched with 98 thrombolyzed patients. The groups were comparable. Compared to thrombolysis, angioplasty had a higher success rate (68 and 91% respectively), resulted in less complications and reduced mortality (11 and 2% respectively), required less revascularization procedures and shorter hospital stay (17 and 13 days, respectively). During the follow-up of survivors, no differences in events or additional mortality were detected at 1 or 5 years. Conclusions: Primary angioplasty is superior as treatment in terms of achieving success and reducing mortality during hospitalization. Evolution after hospitalization is independent of initial therapy.