Primary angioplasty in acute myocardial infarction: initial experience in a developing country

Abstract

Background: Coronary artery disease is a major public health concern worldwide. In Africa, varying rates of progression increased in different countries. In Angola, although the epidemiological scenario is dominated by infectious diseases, the prevalence of coronary artery disease is increasing with notable impacts, requiring the creation of mechanisms to face this reality in a country where lack of specific infrastructure is still a challenge. The objective of this study was to describe the experience of primary angioplasty in patients with acute myocardial infarction in an Angolan tertiary care center. Methods: This was a descriptive, longitudinal, retrospective study, involving 165 patients diagnosed with acute myocardial infarction between 2012 and 2019. Variables were age, sex, risk factors, angiographic and procedure-related characteristics, and main complications. Results: The mean age was 58.3±6.8 years, and males predominated (75.8%). Hypertension (69.7%), dyslipidemia (35.2%), smoking (32.7%) and diabetes (29.7%) were more prevalent. The anterior location was the predominant topography of infarction (49.7%). Single vessel disease was the most common pattern (50.9 %). The left anterior descending artery was the most often involved vessel (49.7%). The door-to-balloon time was 46.6±32.4 minutes. In the multivariate analysis, anterior myocardial infarction (p=0.033), diabetes (p=0.004), age ≥60 years (p≤0.001) and post-coronary intervention final TIMI flow Conclusion: Percutaneous coronary intervention in the context of acute myocardial infarction in Angola is a reality, but the number of procedures performed is not enough given the current great demand.

Prevalência de trombose coronariana após angioplastia primária em pacientes com infarto agudo de miocárdio e COVID-19: uma revisão bibliográfica

“…A angioplastia primária, vem sendo ao longo dos anos, a técnica que reduz os danos da isquemia, melhora o desfecho e preserva a função ventricular na doença cardíaca isquêmica aguda 9 . Entretanto, as citocinas inflamatórias e apoptose de células imunes em infecções virais, através das vesículas extracelulares presentes na própria célula, desempenham papel importante para a ocorrência de trombose e piora do prognóstico na COVID-19 10 , sendo mais comum o desenvolvimento de complicações pós-trombótica a partir do décimo dia de doença 11 .…”