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REC: Interventional Cardiology
versión On-line ISSN 2604-7276versión impresa ISSN 2604-7306
Resumen
RODRIGUEZ-LEOR, Oriol y EN REPRESENTACION DE LOS INVESTIGADORES DEL GRUPO DE TRABAJO DE CODIGO INFARTO DE LA ACI-SEC et al. Regional differences in STEMI care in Spain. Data from the ACI-SEC Infarction Code Registry. REC Interv Cardiol ES [online]. 2023, vol.5, n.2, pp.118-128. Epub 18-Mar-2024. ISSN 2604-7276. https://dx.doi.org/10.24875/recic.m22000360.
Introduction and objectives:
Geographical and organizational differences between different autonomous communities (AC) can generate differences in care for ST-segment elevation myocardial infarction (STEMI). A total of 17 heart attack code programs have been compared in terms of incidence rate, clinical characteristics, reperfusion therapy, delay to reperfusion, and 30-day mortality.
Methods:
National prospective observational study (83 centers included in 17 infarction networks). The recruitment period was 3 months (April 1 to June 30, 2019) with clinical follow-up at 30 days.
Results:
4366 patients with STEMI were included. The incidence rate was variable between different AC (P < .0001), as was gender (P = .003) and the prevalence of cardiovascular risk factors (P < .0001). Reperfusion treatment was primary angioplasty (range 77.5%-97.8%), fibrinolysis (range 0%-12.9%) or no treatment (range 2.2%- 13.5%). The analysis of the delay to reperfusion showed significant differences (P < .001) for all the intervals analyzed. There were significant differences in 30-days mortality that disappeared after adjusting for clinical and healthcare network characteristics.
Conclusions:
Large differences in STEMI care have been detected between the different AC, in terms of incidence rate, clinical characteristics, reperfusion treatment, delay until reperfusion, and 30-day mortality. The differences in mortality disappeared after adjusting for the characteristics of the patient and the care network.
Palabras clave : STEMI; Population characteristics; Angioplasty.