<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0188-2198</journal-id>
<journal-title><![CDATA[Revista mexicana de cardiología]]></journal-title>
<abbrev-journal-title><![CDATA[Rev. Mex. Cardiol]]></abbrev-journal-title>
<issn>0188-2198</issn>
<publisher>
<publisher-name><![CDATA[Asociación Nacional de Cardiólogos de México, Sociedad de Cardiología Intervencionista de México]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0188-21982018000300126</article-id>
<title-group>
<article-title xml:lang="en"><![CDATA[Pharmacoinvasive strategy versus primary angioplasty in patients with acute ST-segment elevation myocardial infarction]]></article-title>
<article-title xml:lang="es"><![CDATA[Estrategia farmacoinvasiva versus angioplastia primaria en pacientes con infarto agudo al miocardio con elevación del segmento ST]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Sierra-Fragoso]]></surname>
<given-names><![CDATA[Ángel Armando]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Galván-García]]></surname>
<given-names><![CDATA[José Eduardo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Vargas-Ramírez]]></surname>
<given-names><![CDATA[Juan Francisco]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Arboine-Aguirre]]></surname>
<given-names><![CDATA[Luis Alberto]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Muñoz-Consuegra]]></surname>
<given-names><![CDATA[Carlos Eder]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Zapata-Ruiz]]></surname>
<given-names><![CDATA[Alejandro]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Palacios-Rodríguez]]></surname>
<given-names><![CDATA[Juan Manuel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Instituto Mexicano del Seguro Social División de Hemodinámica e Intervencionismo de la Unidad Médica de Alta Especialidad ]]></institution>
<addr-line><![CDATA[Monterrey Nuevo León]]></addr-line>
<country>Mexico</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Instituto Mexicano del Seguro Social División de Hemodinámica e Intervencionismo de la Unidad Médica de Alta Especialidad ]]></institution>
<addr-line><![CDATA[Monterrey Nuevo León]]></addr-line>
<country>Mexico</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Instituto Mexicano del Seguro Social División de Hemodinámica e Intervencionismo de la Unidad Médica de Alta Especialidad ]]></institution>
<addr-line><![CDATA[Monterrey Nuevo León]]></addr-line>
<country>Mexico</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,Instituto Mexicano del Seguro Social División de Hemodinámica e Intervencionismo de la Unidad Médica de Alta Especialidad ]]></institution>
<addr-line><![CDATA[Monterrey Nuevo León]]></addr-line>
<country>Mexico</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>09</month>
<year>2018</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>09</month>
<year>2018</year>
</pub-date>
<volume>29</volume>
<numero>3</numero>
<fpage>126</fpage>
<lpage>133</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S0188-21982018000300126&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S0188-21982018000300126&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S0188-21982018000300126&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract:  Background:  Primary percutaneous coronary intervention (PPCI) is the treatment of choice for acute ST-elevation myocardial infarction (STEMI). The delays associated with PPCI reduce the benefits of this therapy. To minimize these delays, the pharmacoinvasive strategy (PS) was developed, consisting of applying thrombolytic therapy followed by coronary angioplasty 2 to 24 hours after.  Objective:  To compare the safety and efficiency of PPCI vs PS in STEMI.  Methods:  We included patients with STEMI who had emergency PCI. The primary endpoint was combined major adverse cardiac events (MACE), death, reinfarction, stroke, target vessel revascularization (TVR) during hospitalization. The secondary endpoints were the individual components of MACE, and major bleeding (Bleeding Academic Research Consortium: BARC &#8805; 3).  Results:  A total of 400 patients, 263 (65.8%) for PPCI group, 114 (28.5%) for PS group and 23 (5.75%) for diagnostic group. The PS group, 79 (69.3%) were then categorized as systematic angioplasty having had a successful thrombolysis, and 35 (30.7%) were rescue angioplasty because they had a failed thrombolysis. There were no differences in MACE: 13 (9.5%) patients in PS and 27 (10.3%) patients in the PPCI (p = 0.806), there were no differences in the individual components of MACE. The rate of major bleeding was the same, 5 (3.6%) and 4 (1.5%) respectively (p = 0.173). The multivariate analysis did not show a relationship between MACE and the reperfusion strategy.  Conclusions:  The pharmacoinvasive strategy when compared to PPCI has a similar rate of primary and secondary endpoints. There is no increase in major bleeding therefore, it is an important strategy that offers a reperfusion therapy for patients with STEMI in a non-PCI capable hospital.]]></p></abstract>
<abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen:  Antecedentes: La intervención coronaria percutánea primaria (ICPP) es el tratamiento de elección en infarto agudo al miocardio con elevación del ST (IAMCEST). El retraso relacionado con ICPP disminuye el beneficio. Buscando una reperfusión oportuna se implementa la estrategia farmacoinvasiva (EFI), que consiste en realizar trombólisis seguido de ICP entre 2 a 24 horas después.  Objetivo: Comparar la seguridad y eficacia en pacientes sometidos a ICPP contra EFI en IAMCEST.  Métodos: Se incluyeron pacientes con IAMCEST sometidos a ICP emergente. El punto final primario son eventos cardiacos adversos mayores (ECAM), muerte, reinfarto, evento vascular cerebral y revascularización del vaso tratado, durante la hospitalización. Los puntos finales secundarios son la presencia de los componentes individuales del ECAM, y el sangrado mayor (BARC &#8805; 3).  Resultados:  Se estudiaron 400 pacientes, 263 (65.8%) de ICPP, 114 (28.5%) a EFI y 23 (5.75%) angiografía diagnóstica. Del grupo EFI, 79 (69.3%) fueron angioplastia sistemática por trombólisis exitosa y 35 (30.7%) por angioplastia de rescate por trombólisis fallida. No se observó diferencia en la frecuencia de ECAM: EFI 13 (9.5%) contra ICPP 27 (10.3%) respectivamente (p = 0.806), tampoco hubo diferencia en los componentes individuales. No se observó diferencia en sangrado mayor, 5 (3.6%) vs 4 (1.5%), (p = 0.173). El análisis multivariado no relacionó la estrategia de reperfusión con los ECAM.  Conclusiones: La EFI comparada con ICPP demuestra una tasa similar de ECAM, así como de sus componentes individuales. No se asocia con aumento de hemorragia mayor, concluyendo que ofrece el beneficio de una reperfusión oportuna sin aumento del riesgo en los hospitales que no tienen la capacidad para realizar ICPP.]]></p></abstract>
<kwd-group>
<kwd lng="en"><![CDATA[Acute myocardial infarction]]></kwd>
<kwd lng="en"><![CDATA[thrombolysis]]></kwd>
<kwd lng="en"><![CDATA[primary angioplasty]]></kwd>
<kwd lng="en"><![CDATA[pharmacoinvasive therapy]]></kwd>
<kwd lng="es"><![CDATA[Infarto agudo al miocardio]]></kwd>
<kwd lng="es"><![CDATA[trombólisis]]></kwd>
<kwd lng="es"><![CDATA[angioplastia primaria]]></kwd>
<kwd lng="es"><![CDATA[terapia farmacoinvasiva]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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