[Position statement for improvement in reperfusion of ST-elevation myocardial infarction in Latin America].

Juan P Costabel, Miguel Quintana, Joaquín Perea, Pablo Lamelas, Alfonsina Candiello, Patricio Sanhueza, Alexandra Arias-Mendoza, Iván Saavedra, Alex Rivera-Toquica, Marildes L de Castro, Manuel Álvarez-Gaviria, Jorge Belardi, Ángel Cequier, Álvaro Sosa-Liprandi, Ricardo Villarreal
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Abstract

The treatment of ST-segment elevation myocardial infarction has barriers depending on the geographic region. Primary coronary angioplasty is the treatment of choice, if it is performed on time and by experienced operators. However, when it is not available, the administration of fibrinolysis and referral for rescue angioplasty, in case of negative reperfusion, is the best strategy. In the same way, coronary angioplasty, as part of a pharmacoinvasive strategy, is the best alternative when there is positive reperfusion. The development of infarct treatment networks increases the number of patients reperfused within the recommended times and improves outcomes. In Latin America, national myocardial infarction treatment programs should focus on improving outcomes, and long-term success depends on working toward defined goals and enhancing functionality, therefore programs should develop capacity to measure their performance. The following document discusses all of these alternatives and suggests opportunities for improvement.

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[关于改善拉丁美洲 ST 段抬高型心肌梗死再灌注的立场声明]。
ST 段抬高型心肌梗死的治疗因地域不同而存在障碍。原发性冠状动脉血管成形术是首选的治疗方法,但必须由经验丰富的操作人员及时实施。但是,如果不能及时进行冠状动脉成形术,最好的办法是进行纤维蛋白溶解术,并在再灌注不良的情况下转诊进行抢救性血管成形术。同样,作为药物介入策略的一部分,冠状动脉血管成形术也是再灌注阳性情况下的最佳选择。心梗治疗网络的发展增加了在建议时间内再灌注的患者人数,并改善了治疗效果。在拉丁美洲,国家心肌梗死治疗计划应将重点放在改善预后上,长期的成功取决于努力实现既定目标和增强功能,因此计划应发展衡量其绩效的能力。以下文件讨论了所有这些替代方案,并提出了改进建议。
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