Reperfusion therapy of myocardial infarction in Mexico: A challenge for modern cardiology.
Mexico has been positioned as the country with the highest mortality attributed to myocardial infarction among the members of the Organization for Economic Cooperation and Development. This rate responds to multiple factors, including a low rate of reperfusion therapy and the absence of a coordinated system of care. Primary angioplasty is the reperfusion method recommended by the guidelines, but requires multiple conditions that are not reached at all times. Early pharmacological reperfusion of the culprit coronary artery and early coronary angiography (pharmacoinvasive strategy) can be the solution to the logistical problem that primary angioplasty rises. Several studies have demonstrated pharmacoinvasive strategy as effective and safe as primary angioplasty ST-elevation myocardial infarction, which is postulated as the choice to follow in communities where access to PPCI is limited. The Mexico City Government together with the National Institute of Cardiology have developed a pharmaco-invasive reperfusion treatment program to ensure effective and timely reperfusion in STEMI. The model comprises a network of care at all three levels of health, including a system for early pharmacological reperfusion in primary care centers, a digital telemedicine system, an inter-hospital transport network to ensure primary angioplasty or early percutaneous coronary intervention after fibrinolysis and a training program with certification of the health care personal. This program intends to reduce morbidity and mortality associated with myocardial infarction.
Unidad Coronaria, Instituto Nacional de Cardiología Ignacio Chávez, Ciudad de México, Mexico.
Carlos
C
Martínez-Sánchez
Unidad Coronaria, Instituto Nacional de Cardiología Ignacio Chávez, Ciudad de México, Mexico. Electronic address: aariasm@yahoo.com.
Alexandra
A
Arias-Mendoza
Unidad Coronaria, Instituto Nacional de Cardiología Ignacio Chávez, Ciudad de México, Mexico.
Héctor
H
González-Pacheco
Departamento de Cardiología, Instituto Nacional de Cardiología Ignacio Chávez, Ciudad de México, Mexico.
Diego
D
Araiza-Garaygordobil
Departamento de Cardiología, Instituto Nacional de Cardiología Ignacio Chávez, Ciudad de México, Mexico.
Luis Alfonso
LA
Marroquín-Donday
Departamento de Cardiología, Instituto Nacional de Cardiología Ignacio Chávez, Ciudad de México, Mexico.
Jorge
J
Padilla-Ibarra
Unidad Coronaria, Instituto Nacional de Cardiología Ignacio Chávez, Ciudad de México, Mexico.
Carlos
C
Sierra-Fernández
Unidad Coronaria, Instituto Nacional de Cardiología Ignacio Chávez, Ciudad de México, Mexico.
Alfredo
A
Altamirano-Castillo
Unidad Coronaria, Instituto Nacional de Cardiología Ignacio Chávez, Ciudad de México, Mexico.
Amada
A
Álvarez-Sangabriel
Unidad Coronaria, Instituto Nacional de Cardiología Ignacio Chávez, Ciudad de México, Mexico.
Francisco Javier
FJ
Azar-Manzur
Unidad Coronaria, Instituto Nacional de Cardiología Ignacio Chávez, Ciudad de México, Mexico.
José Luis
JL
Briseño-de la Cruz
Unidad Coronaria, Instituto Nacional de Cardiología Ignacio Chávez, Ciudad de México, Mexico.
Salvador
S
Mendoza-García
Unidad Coronaria, Instituto Nacional de Cardiología Ignacio Chávez, Ciudad de México, Mexico.
Yigal
Y
Piña-Reyna
Dirección General, Instituto Nacional de Cardiología Ignacio Chávez, Ciudad de México, Mexico.
Marco Antonio
MA
Martínez-Ríos
D002309:Cardiology / Q000379:methods / Q000639:trends; D003131:Combined Modality Therapy; D006801:Humans; D008800:Mexico; D009203:Myocardial Infarction / Q000188:drug therapy / Q000601:surgery*; D015425:Myocardial Reperfusion
Estrategia; Infarction; Infarto; Mexico; Miocardio; Myocardial; México; Pharmacoinvasive; Reperfusion; Reperfusión; Strategy