Stent-Save a Life! Argentina Initiative

Alfonsina Candiello, Ignacio Cigalini, Pedro Zangroniz, Alejandro García Escudero, Leonardo Ripa, Leandro Lasave, Fernando Cohen, Andrés Pascua, Santiago Coroleu, Jorge Belardi

Abstract


Introduction: The Stent-Save a Life! (SSL) initiative is a European program that seeks to improve the access of patients withST-segment elevation acute myocardial infarction (STEMI) to reperfusion therapies based on clinical guideline recommendations,thus reducing morbidity and mortality.Objective: The aim of this study was to describe the results of the first three years of the SSL Argentina initiativeMethods: Initially, a mapping was carried out to analyze the local situation and then the Door-to- Balloon Program (DBP) wasdeveloped as a continuous improvement process for centers with primary percutaneous coronary intervention (pPCI) capability.Results: From March 2016 to March 2018, 3,041 patients with STEMI were treated in 38 centers participating in this program.In 20% of cases (n=610) patients had their first medical contact with the emergency medical services. After excluding 184 patients(6%) without coronary lesions, reperfusion therapy was performed in 93% of cases, mainly by pPCI (95%). Total ischemictime was 117 minutes, with differences according to the time of first medical contact. Overall in-hospital mortality was 7%.Conclusions: The lack of a “reperfusion culture” was the common barrier of public and private centers that motivated thedevelopment of the DBP. The identification of critical points that prevent treatment on time, together with enhancement ofin-hospital organization, represent the first step to improve the care of these patients. The integrated work of all the involvedparties is necessary to develop care networks adapted to the local reality of each center and region.

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Revista argentina de cardiología. ISSN en línea 1850-3748. Argentine journal of cardiology (English ed. Online ISSN 2314-2286) Sociedad Argentina de Cardiología. Azcuénaga 980 (C1115AAD),Ciudad Autónoma de Buenos Aires, República Argentina. Tel. (54 11) 4961-6027/8/9 Fax: 4961-6020 www.sac.org.ar revista@sac.org.ar