• 作者：Romá ; n Lezá ; un ; ^{rlezaunb@navarra.es} ; Marí ; a Soledad Alcasena ; Marí ; a Teresa Basurte ; Jesú ; s Berjó ; n ; Cé ; sar Maraví ; Miguel Aleu ; José ; Ramó ; n Carmona ; Nuria Basterra ; Miguel A. Imizcoz ; Javier Abad
• 关键词：Cardiopatí ; a isqué ; mica ; Infarto de miocardio ; Reperfusió ; n ; Intervenció ; n coronaria percut&aacute ; nea primaria ; Red de reperfusió ; n
• 刊名：Revista Espa?ola de Cardiolog篓陋a Suplementos
• 出版年：2011
• 期刊代码：pca309_11313587
• 类别：med
• 出版时间：2011
• 卷：11
• 期：supp_S3
• 页码：21-27
• 文件大小：209 K

The treatment of acute myocardial infarction has advanced considerably over the last three decades. Today, the benefits of reperfusion therapy are abundantly clear: it can reduce morbidity and mortality in a disease that has a very high prevalence in developed countries. If the various reperfusion treatments are used early after symptom onset, mortality due to myocardial infarction may be less than 5%, a level that was unthinkable just a few years ago. Primary percutaneous coronary intervention is the ideal reperfusion method. However, for the community as a whole in a region where distances are large and there may be a lengthy delay between symptom onset and hospital admission, pharmacological reperfusion with simultaneous transport for rescue percutaneous coronary intervention, if warranted, may be an alternative, and outcomes are not inferior to those of primary percutaneous coronary intervention when this is the only option. In the region of Navarre in Spain, a relatively extensive area (i.e. 10 391 km²) is covered by three public hospitals: the Complejo Hospitalario de Navarra in Pamplona and two district hospitals in Estella and Tudela, located 50 km and 90 km, respectively, from the interventional cardiology service in Pamplona. Strategically, the goal is to provide reperfusion therapy for the maximum possible number of patients with ST-elevation myocardial infarction. Primary percutaneous coronary intervention is always performed in patients from the area around Pamplona and North Pamplona. In areas served by the district hospitals in Estella and Tudela, either invasive treatment or the combination of pharmacological and invasive therapy may be used depending on the sum total of the time between symptom onset and first contact with the health system plus the theoretical transfer time to the interventional cardiology service in Pamplona. The use of this combination treatment strategy, based on well-defined protocols, in a region like Navarre, which is characterized a mixture of urban and rural communities, appears to be very effective and, within its limitations, the program was simple to implement.