title: [Alteplase in acute coronary syndromes].
abstract: OBJECTIVE
  The registry intends to establish the safety and security of one-hour 100 mg alteplase infusion and 50 mg in 30 minutes to facilitate percutaneous coronary intervention (PCI) in a cardiology hospital with primary angioplasty program (24 hours 365 days a year) with current doses of unfractionated heparin and enoxaparin.
  
  
  RESULTS
  REALSICA II is a prospective registry that included 103 patients with final diagnosis of ST elevation myocardial infarction in which Alpert's quality criteria were used. Seventy two patients were under one-hour 100 mg alteplase infusion and thirty one under 30 minutes 50 mg alteplase infusion to facilitate PCI. Patients were young and predominantly males. In both groups > 50% had extensive ST elevation myocardial infarction and 68% were Killip & Kimball I. The majority received reperfusion > 3 hours after the onset of symptoms. In-hospital and follow-up treatment were compliant with Mexican Cardiology Society guidelines. ECG reperfusion was observed in 59% and TIMI III flow in 19% of PCI group. Any intracranial hemorrhage was observed. Global cardiovascular mortality was 11%. Patients under PCI had low incidence of recurrent ischemia and reinfarction.
  
  
  CONCLUSIONS
  REALSICA registry showed in non-complicate acute myocardial infarction ST elevation safety and security of one-hour 100 mg alteplase infusion with current recommended unfractionated heparin and enoxaparin doses in ST elevation myocardial infarction. In complicated patients the regimen to facilitate PCI was associated with increased hemorrhagic complications and requires further research.
authors.affiliation: Hospital de Cardiología UMAE 34, Institute Mexicano del Seguro Social.
authors.forename: Mario
authors.initials: M
authors.lastname: Iturbe Orbe
authors.forename: Carlos
authors.initials: C
authors.lastname: Jerjes-Sánchez Diaz
authors.forename: Anabel
authors.initials: A
authors.lastname: García-Sosa
authors.forename: Héctor
authors.initials: H
authors.lastname: García
authors.forename: Esteban
authors.initials: E
authors.lastname: Reyes Cerezo
authors.forename: Dolores
authors.initials: D
authors.lastname: Fernández
authors.forename: Angel
authors.initials: A
authors.lastname: Garza Ruiz
authors.forename: Christian
authors.initials: C
authors.lastname: Assad
authors.forename: Francisco
authors.initials: F
authors.lastname: Castillo
authors.forename: Miguel
authors.initials: M
authors.lastname: González
authors.forename: Jerónimo
authors.initials: J
authors.lastname: García
authors.forename: Francisco
authors.initials: F
authors.lastname: Valadéz
authors.forename: Mario
authors.initials: M
authors.lastname: Chávez
authors.forename: Oscar
authors.initials: O
authors.lastname: Garza
mesh_terms: D054058:Acute Coronary Syndrome / Q000628:therapy*; D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D003131:Combined Modality Therapy; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008800:Mexico; D008875:Middle Aged; D009203:Myocardial Infarction / Q000628:therapy; D012042:Registries; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage*
chemical_list: D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator