title: [Angioplasty compared to thrombolysis as the initial reperfusion therapy in acute myocardial infarction].
abstract: BACKGROUND
  Primary angioplasty is superior to intravenous thrombolysis as reperfusion therapy for acute myocardial infarction.
  
  
  OBJECTIVE
  To compare the results of available reperfusion strategies for initial management of acute myocardial infarction during hospitalization and 5 years follow up.
  
  
  METHODS
  Historical cohort study from a prospective registry of patients admitted with acute myocardial infarction to our center. Patients treated with primary angioplasty were identified and were then matched by age, sex and date of event with patients treated with throm-bolysis. The clinical outcomes were compared including hospitalization and 5-years follow-up.
  
  
  RESULTS
  From March 1993 to August 2001, 98 patients were treated with primary angioplasty and matched with 98 thrombolyzed patients. The groups were comparable. Compared to thrombolysis, angioplasty had a higher success rate (68 and 91% respectively), resulted in less complications and reduced mortality (11 and 2% respectively), required less revascularization procedures and shorter hospital stay (17 and 13 days, respectively). During the follow-up of survivors, no differences in events or additional mortality were detected at 1 or 5 years.
  
  
  CONCLUSIONS
  Primary angioplasty is superior as treatment in terms of achieving success and reducing mortality during hospitalization. Evolution after hospitalization is independent of initial therapy.
authors.affiliation: Departamento Cardiología, Hospital Clínico, Universidad de Chile, Chile. ugalde_hector@gmail.com
authors.forename: Héctor
authors.initials: H
authors.lastname: Ugalde
authors.forename: Diego
authors.initials: D
authors.lastname: Ugalde
authors.forename: Macarena
authors.initials: M
authors.lastname: Muñoz
mesh_terms: D015906:Angioplasty, Balloon, Coronary / Q000379:methods*; D002677:Chile; D004812:Epidemiologic Methods; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000628:therapy*; D015425:Myocardial Reperfusion / Q000379:methods*; D013300:Streptokinase / Q000627:therapeutic use*; D015912:Thrombolytic Therapy / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D005343:Fibrinolytic Agents; D013300:Streptokinase