Stent-Save a Life! Argentina Initiative

Abstract

The Stent-Save a Life! Initiative (SSL) is a European program that seeks to improve access of patients with acute myocardial infarction with ST-segment elevation (STEMI) to reperfusion therapies according to guideline recommendations, thus reducing morbidity and mortality. Objectives: To describe the results of the first three years of the SSL Initiative in Argentina. Methods: A mapping was carried out initially to analyze the local situation and a Door-to-Balloon Program (DBP) was developed for centers with primary percutaneous coronary intervention (pPCI) capability. Results: The lack of reperfusion culture with poor in-hospital organization was a common point in both public and private centers, triggering the development of the DBP. Since March-2016 to March-2018, 3041 patients with STEMI were included in 38 centers. Of these, 610 (20%) had their first medical contact (FMC) in emergency medical services. After excluding 184 (6%) patients without coronary lesions, reperfusion therapy was performed in 93% of the cases, mainly by pPCi. The total ischemic time was 117 minutes, with differences according to FMC. In-hospital mortality was 7%. Conclusions: Identification of barriers and the enhancement of in-hospital organization represent the first step to improve the care of STEMI patients. Integrated work is necessary to develop networks adapted to the local reality of each center and region.