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STEMI and NSTEMI: Real-world Study in Mexico (RENASCA).

Gabriela Borrayo-Sánchez1, Martín Rosas-Peralta2, Erick Ramírez-Arias3

  • 1Programa "A Todo Corazón", Centro Médico, Nacional, Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México, México.

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Summary
This summary is machine-generated.

Mexico faces high acute myocardial infarction mortality. The RENASCA IMSS study reveals a high-risk population and improved reperfusion strategies, reducing mortality in ST-elevation myocardial infarction (STEMI) patients.

Keywords:
Acute coronary syndromeCode infarctionNSTEMINational RegistryRENASCARisk stratificationSTEMI

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Area of Science:

  • Cardiology
  • Public Health
  • Epidemiology

Background:

  • Mexico has the highest adult mortality from acute myocardial infarction (AMI) among OECD countries.
  • The RENASCA IMSS study identified a high-risk AMI population with suboptimal reperfusion rates.

Purpose of the Study:

  • To describe the clinical presentation, treatment, and outcomes of acute coronary syndromes (ACS) within the Mexican healthcare system (IMSS).

Main Methods:

  • A nationwide, prospective, longitudinal-cohort study (RENASCA IMSS) involving 21,827 patients across 177 hospitals.
  • Data collected via an electronic database included clinical characteristics, risk factors, reperfusion strategies, and outcomes.
  • Rigorous data calibration ensured over 80% accuracy for variables and cases.

Main Results:

  • The study enrolled 21,827 patients (average age 63.2 years, 75% male) with prevalent risk factors like hypertension (60.5%) and smoking (46.8%).
  • ST-elevation myocardial infarction (STEMI) constituted 73.2% of cases.
  • The 'Code Infarction' strategy significantly improved reperfusion therapy (34.9% to 71.4%) and reduced mortality (21.1% to 9.4%) in STEMI patients.

Conclusions:

  • The RENASCA IMSS study is the largest real-world ACS study in Mexico, confirming a high-risk profile in the Mexican population.
  • STEMI patients faced higher mortality and complications, but the 'Code Infarction' initiative demonstrated improved outcomes.
  • Further efforts are needed to optimize ACS management and reduce mortality in Mexico.