Plan de actuación conjunta en el infarto agudo de miocardio (PACIAM)

Arboleda Sánchez, J.A.; Siendones Castillo, R.; González Rodríguez, J.V.; Romero Oloriz, C.; Agüera Urbano, C.; Marfil Robles, J.L.; Grupo, Ariam

doi:10.1016/S0210-5691(00)79612-4

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Resumen

Bibliografía

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Estadísticas

El mayor beneficio del tratamiento trombolítico en el infarto agudo de miocardio (IAM) se obtiene cuando se administra dentro de las dos primeras horas de evolución. Pese a la rapidez con que se realiza este tratamiento en nuestro Hospital, sólo un 15%-20% de las trombolisis se realizaban dentro de estas dos primeras horas, debido fundamentalmente a la demora en la llegada del paciente al hospital. Por este motivo hemos desarrollado el Plan de Actuación Conjunta en el Infarto Agudo de Miocardio (PACIAM), con el objetivo de aumentar el número de trombolisis precoces, mediante un protocolo de trombolisis extrahospitalaria que garantizase su seguridad y fiabilidad.

Palabras clave:

infarto agudo de miocardio

trombolisis

atención extrahospitalaria

The main benefit from thrombolytic treatment in acute myocardial infarction (AMI) is obtained when administered within the first two hours of symptoms. Although thrombolysis is timely started upon arrival of the patient to our hospital, only 15%-20% were started within these two hours, mainly because the delay in the arrival of the patient to hospital. For this reason we developed a Joint Management Plan of Acute Myocardial Infarction, with the objective of increasing early thrombolysis, using an pre-hospital thrombolysis protocol warranting security and reliability

Key words:

Acute myocardial infarction

thrombolysis

prehospital care

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Bibliografía

[1.]

Fibrinolytic Therapy Trialists (FTT) Collaborative Group. Indications for fibrinolytic therapy in suspected acute myocardial infartion: collaborative overview of early mortalitymajor morbidity results from all randomised trials of more than 1000 patients.

Lancet, 343 (1994), pp. 311-322

Medline

[2.]

E. Boersma, A.C. Maas, J.W. Deckers, M.L. Simoons.

Early thrombolytic treatment in acute myocardial infarction; reappraisal of the golden hour.

Lancet, 348 (1996), pp. 771-775

http://dx.doi.org/10.1016/S0140-6736(96)02514-7 | Medline

[3.]

A report of the American College of Cardiology/ American Heart Association Task Force on Practice Guidelines (Committee on Management of Acute Myocardial Infarction). Update 1999: ACC/AHA Guidelines for the management of patients with acute myocardial infarction.

JACC, 34 (1999), pp. 890-911

Medline

[4.]

European Resucitation Council. The prehospital management of acute heart attacks. Recommendations of a task force of the European Society of Cardiology and the European Resucitation Council.

Eur Heart J, 19 (1998), pp. 140-164

[5.]

J.A. Arboleda, R. Siendones, J.F. Prieto, J.B. Zayas, Y. Fernández, R. Molina.

y grupo ARIAM. Atención médica al síndrome coronario agudo en el ámbito prehospitalario.

Med Intensiva, 23 (1999), pp. 306-312

[6.]

E. Aguayo, A. Reina, M. Colmenero, M. Barranco, M.D. Pola.

y Proyecto ARIAM. Análisis de los retrasos en el registro ARIAM.

Med Intensiva, 23 (1999), pp. 280-287

[7.]

The European Myocardial Infarction Project Group. Prehospital thrombolytic therapy in patients with suspected acute myocardial infarction.

N Engl J Med, 329 (1993), pp. 383-389

http://dx.doi.org/10.1056/NEJM199308053290602 | Medline

[8.]

W.D. Weawer, M. Cerqueira, A.P. Hallstrom, P.E. Litwin, J.S. Martin, P.J. Kudenchuk, M. Eisenberg.

Prehospital-initiated vs Hospital-initiated thrombolytic therapy. The myocardial infarction triage abd intervention trial.

JAMA, 270 (1994), pp. 1.211-1.216

Medline

[9.]

GREAT Group. Feasibility, safety, and efficacy of domiciliary thrombolysis by general practitioners: Grampian region early anistreplase trial.

Br Med J, 305 (1992), pp. 548-553

[10.]

M. Álvarez, A. Vera, J.J. Rodríguez, J.A. Ferriz, T. García, A. García.

y Grupo ARIAM. Monográfico ARIAM.

Med Intensiva, 23 (1999), pp. 273-279

[11.]

J.M. Rawles.

Quantification of the benefit of earlier thrombolytic therapy: five-year results of the grampian region early anistreplase trial (GREAT.

JACC, 30 (1997), pp. 1181-1186

Medline

[12.]

E. Torrado, J.A. Ferriz, A. Vera, M. Álvarez, J.J. Rodríguez, P. Gónzalez-Villasonte, et al.

Tratamiento trombolítico del infarto agudo de miocardio en el área de urgencias.

Rev Esp Cardiol, 50 (1997), pp. 689-695

Medline

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