title: [Prehospital thrombolysis: A national perspective. Pharmaco-invasive strategy for early reperfusion of STEMI in Mexico].
abstract: OBJECTIVE
  To review the existing evidence on the role of prehospital thrombolysis in patients with ST-segment elevation acute myocardial infarction (STEMI) as part of a strategy of cutting edge to reduce the time of coronary reperfusion and as a consequence improves both the survival and function.
  
  
  METHODS
  We used the technique of exploration-reduction-evaluation-analysis and synthesis of related studies, with an overview of current recommendations, data from controlled clinical trials and from the national and international registries about the different strategies for STEMI reperfusion. In total, we examined 186 references on prehospital thrombolysis, 130 references in times door-treatment, 139 references in STEMI management and national and international registries as well as 135 references on rescue and primary percutaneous coronary intervention for STEMI. Finally the 48 references that were more relevant and informative were retained.
  
  
  CONCLUSIONS
  The «time» factor is crucial in the success of early reperfusion in STEMI especially if thrombolysis is applied correctly during the prehospital time. The primary percutaneous coronary intervention is contingent upon its feasibility before 120 min from the onset of symptoms. In our midst to internationally, thrombolysis continues to be a strategy with great impact on their expectations of life and function of patients. Telecommunication systems should be incorporate in real time to the priority needs of catastrophic diseases such as STEMI where life is depending on time.
authors.affiliation: División Médica, Hospital de Cardiología, Unidad Médica de Alta Especialidad, Centro Médico Nacional Siglo XXI, México, D. F., México.
authors.forename: Roberto
authors.initials: R
authors.lastname: Arriaga-Nava
authors.affiliation: Dirección de Enseñanza e Investigación, Hospital de Cardiología, Unidad Médica de Alta Especialidad, Centro Médico Nacional Siglo XXI, México, D. F., México.
authors.forename: Jesús-Salvador
authors.initials: JS
authors.lastname: Valencia-Sánchez
authors.affiliation: Investigación en Salud, Hospital de Cardiología, Unidad Médica de Alta Especialidad, Centro Médico Nacional Siglo XXI, México, D. F., México; Academia Nacional de Medicina de México, A. C., México, D. F., México. Electronic address: mrosas_peralta@hotmail.com.
authors.forename: Martin
authors.initials: M
authors.lastname: Rosas-Peralta
authors.affiliation: División Médica, Hospital de Cardiología, Unidad Médica de Alta Especialidad, Centro Médico Nacional Siglo XXI, México, D. F., México.
authors.forename: Martin
authors.initials: M
authors.lastname: Garrido-Garduño
authors.affiliation: Dirección General, Hospital de Cardiología, Unidad Médica de Alta Especialidad, Centro Médico Nacional Siglo XXI, México, D. F., México.
authors.forename: Moisés
authors.initials: M
authors.lastname: Calderón-Abbo
mesh_terms: D061345:Early Medical Intervention; D004632:Emergency Medical Services; D006801:Humans; D008800:Mexico; D009203:Myocardial Infarction / Q000188:drug therapy* / Q000503:physiopathology / Q000601:surgery; D015425:Myocardial Reperfusion; D012042:Registries; D015912:Thrombolytic Therapy
keywords: Elevación del segmento ST en el infarto agudo de miocardio; Estrategia farmacoinvasiva; México; Pharmaco-invasive strategy; Prehospital thrombolysis; ST-segment elevation acute myocardial infarction; Trombólisis prehospitalaria