Caracterización clínica-epidemiológica de pacientes con infarto agudo de Miocardio con elevación del ST que recibieron tratamiento con Alteplasa en el Hospital de Especialidades Teodoro Maldonado Carbo durante el período enero 2022 - junio 2024.

Abstract

Introduction: Acute myocardial infarction (AMI) is a high-mortality emergency caused by coronary obstruction. It is more frequent in individuals with cardiovascular risk factors. Treatment aims to restore blood flow, with alteplase being the preferred fibrinolytic to improve prognosis and reduce complications. Methods: Analytical, cross-sectional, and retrospective study on the clinical-epidemiological characteristics of patients with ST-segment elevation myocardial infarction (STEMI) treated with alteplase at HETMC. Data were obtained through the review of medical records, collected in Microsoft Excel, and analyzed using SPSS Real Statistics to generate descriptive and analytical statistics, Kendall correlation, and odds ratio with significance <0.05. Results: A total of 200 patients were studied, mostly men over 65 years old. 63% had a pre-hospital course of less than 4 hours, and 45% were hospitalized for 0 to 5 days. Upon admission, 89% did not require intubation, with predominant symptoms of precordial pain and dyspnea, primarily affecting the anteroseptal region. The most common risk factors were smoking and hypertension. 55% of patients were classified as Killip/Kimball Grade I, with a thrombolysis success rate of 67%. Early thrombolysis (<4 hours) and being between 40 to 65 years of age were associated with greater reperfusion success, while diabetes, alcoholism, age >65, precordial pain radiating to the right, Killip/Kimball III/IV classification, and delayed thrombolysis (>4 hours) reduced effectiveness. Alcoholism, female sex, smoking, physical inactivity, and anteroseptal involvement increased the risk of death. Conclusions: Risk factors for therapeutic failure included age >65 years, precordial pain radiating to the right, alcoholism, diabetes, Killip/Kimball III/IV classification, and delayed thrombolysis. Female sex, physical inactivity, smoking, alcoholism, anteroseptal infarction, and precordial pain radiating to the left were associated with higher mortality.