National Survey of st-elevation myocardial infarction in Argentina (ARGENT-IAM-ST)

Abstract

ST-Elevation myocardial infarction (STEMI) is one of the most challenging diseases in the health system. It is necessary to have a registry of robust enough information to adopt public policies and guidelines tailored to national needs. The Sociedad Argentina de Cardiología (SAC) and Federación Argentina de Cardiología (FAC) are conducting a national registry of STEMI trying to reach the “universe”, evaluating clinical aspects, delays, treatment and results as well as possible barriers to be improved. There were 1759
patients included from 247 centers across the country between March and December 2015. 83.5% received reperfusion therapy, 78.3% of which was performed by primary angioplasty. 37% of patients were admitted referred from another institution, but only 16% of them received fibrinolytic agents before referral. Only 25% of patients who received fibrinolytic therapy had a door-to-needle time ≤30 minutes and 47.7% of patients treated with primary PCI had a door-to-balloon ≤90 minutes. The in-hospital mortality was 8.8%. These data allow drawing a map of the reality of AMI in Argentina. Delays to treatment are important and there are several items to correct. These data suggest the need to implement corrective measures such as implementing programs of medical education, strategies of adjuvant health policies, consider regional characteristics and cost / benefit in the field of reperfusion strategies, which could contribute to shorten the time to reperfusion for both thrombolytic and for primary  angioplasty.