Título:
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Secondary prevention strategies after an acute ST-segment elevation myocardial infarction in the AMI code era : beyond myocardial mechanical reperfusion
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Autor/a:
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Ribas, Núria; Garcia Garcia, Cosme; Meroño, Oona; Recasens, Lluís; Pérez-Fernández, Silvia; Bazán, Víctor; Salvatella, Neus; Martí-Almor, Julio; Bruguera Cortada, Jordi; Elosua, Roberto; Universitat Autònoma de Barcelona
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Abstract:
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The AMI code is a regional network enhancing a rapid and widespread access to reperfusion therapy (giving priority to primary angioplasty) in patients with acute ST-segment elevation myocardial infarction (STEMI). We aimed to assess the long-term control of conventional cardiovascular risk factors after a STEMI among patients included in the AMI code registry. Four hundred and fifty-four patients were prospectively included between June-2009 and April-2013. Clinical characteristics were collected at baseline. The long-term control of cardiovascular risk factors and cardiovascular morbidity/mortality was assessed among the 6-months survivors. A total of 423 patients overcame the first 6 months after the STEMI episode, of whom 370 (87%) underwent reperfusion therapy (363, 98% of them, with primary angioplasty). At 1-year follow-up, only 263 (62%) had adequate blood pressure control, 123 (29%) had LDL-cholesterol within targeted levels, 126/210 (60%) smokers had withdrawn from their habit and 40/112 (36%) diabetic patients had adequate glycosylated hemoglobin levels. During a median follow-up of 20 (11-30) months, cumulative mortality of 6 month-survivors was 6.1%, with 9.9% of hospital cardiovascular readmissions. The lack of assessment of LDL and HDL-cholesterol were significantly associated with higher mortality and cardiovascular readmission rates. Whereas implementation of the AMI code resulted in a widespread access to rapid reperfusion therapy, its long-term therapeutic benefit may be partially counterbalanced by a manifestly suboptimal control of cardiovascular risk factors. Further efforts should be devoted to secondary prevention strategies after STEMI. The online version of this article (doi:10.1186/s12872-017-0493-6) contains supplementary material, which is available to authorized users. |
Materia(s):
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-ST-segment elevation myocardial infarction -Coronary angioplasty -Secondary prevention -Prognosis -Reperfusion therapy -Cardiovascular risk factors |
Derechos:
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open access
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Article |
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Uri:
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https://ddd.uab.cat/record/186145
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