Publication: Evolución a largo plazo de la función ventricular izquierda en pacientes con infarto de miocardio tratados con tirofibán intravenoso tras una fibrinolisis eficaz y antes de una angioplastia rutinaria precoz
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2018-11-27
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Universidad Complutense de Madrid
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Abstract
El infarto agudo de miocardio es la tercera causa de muerte en varones y la quinta en el conjunto de población en nuestro país y genera una amplia morbilidad, por lo que supone un importante consumo de recursos económicos.El infarto agudo de miocardio consiste en la oclusión trombótica de una arteria coronaria que, con el paso del tiempo, produce una necrosis del músculo cardiaco.La función ventricular izquierda residual tras un infarto agudo de miocardio es el mayor condicionante de la supervivencia a corto y largo plazo. Se ha comprobado que la recuperación de la función sistólica del ventrículo izquierdo y la reducción de la mortalidad global están directamente relacionadas con la restauración precoz, completa y mantenida, tanto del flujo coronario en la arteria responsable del infarto, como de la perfusión tisular en el territorio que riega...
Acute myocardial infarction is the third cause of death in male populationand the fifth in the overall population in Spain. It causes wide morbidity, whichleads to an important economic resource consumption. Acute myocardialinfarction is the thrombotic occlusion of a coronary artery that, over time, causesnecrosis of the cardiac muscle.Left ventricular function after an acute myocardial infarction is the majordeterminant of short- and long-term survival. The recovery of left ventricularsystolic function and the reduction in overall mortality have been shown to bedirectly related to the early, complete and sustained restoration of both coronaryflow in the infarction related artery and the tissue perfusion in the correspondingterritory of the left ventricle.Primary percutaneous coronary intervention is the preferred reperfusiontreatment in patients with acute ST-elevation myocardial infarction. However,primary percutaneous coronary intervention is not available worldwide, and thisis still the main limitation of its application. Routine angioplasty after fibrinolysisprovides similar results to those of primary angioplasty and superior to those oflate- or ischemia-guided angioplasty, meaning it improves the prognosis ofpatients who do not have the desirable logistical availability for primaryangioplasty...
Acute myocardial infarction is the third cause of death in male populationand the fifth in the overall population in Spain. It causes wide morbidity, whichleads to an important economic resource consumption. Acute myocardialinfarction is the thrombotic occlusion of a coronary artery that, over time, causesnecrosis of the cardiac muscle.Left ventricular function after an acute myocardial infarction is the majordeterminant of short- and long-term survival. The recovery of left ventricularsystolic function and the reduction in overall mortality have been shown to bedirectly related to the early, complete and sustained restoration of both coronaryflow in the infarction related artery and the tissue perfusion in the correspondingterritory of the left ventricle.Primary percutaneous coronary intervention is the preferred reperfusiontreatment in patients with acute ST-elevation myocardial infarction. However,primary percutaneous coronary intervention is not available worldwide, and thisis still the main limitation of its application. Routine angioplasty after fibrinolysisprovides similar results to those of primary angioplasty and superior to those oflate- or ischemia-guided angioplasty, meaning it improves the prognosis ofpatients who do not have the desirable logistical availability for primaryangioplasty...
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Tesis de la Universidad Complutense de Madrid, Facultad de Medicina, Departamento de Medicina, leída el 10-07-2017