[Proposal for initial management of uncomplicated ST elevation myocardial infarction in centers without percutaneous coronary intervention capacity in Peru].

ST-segment elevation myocardial infarction (STEMI) is a clinical entity whose adequate treatment will depend on its prompt recognition, accurate diagnosis, and management in reperfusion networks. The first contact with these patients is generally done in centers without reperfusion capacity, attended by non-cardiologist doctors, and in centers far from hospitals with greater resolution capacity, something that is well known in our country. This manuscript proposes a strategy for the diagnosis and treatment of STEMI in centers without percutaneous coronary intervention capacity of the public health system in Peru, emphasizing not losing sight of electrocardiographic patterns compatible with coronary artery occlusion, adequate fibrinolysis and management of its complications, the treatment of infarction in special populations and highlighting the importance of the pharmacoinvasive strategy as the main form of reperfusion treatment in our country.

[One-year survival among patients with ST-elevation myocardial infarction in Peru].

Objectives: To determine one-year survival and factors associated with mortality in patients with ST-segment elevation myocardial infarction in Peru.

Methods: An analysis was made of the cohort of patients included in the PERSTEMI-II registry during the year 2020, in whom survival at one year after the event and its risk factors were evaluated using Kaplan-Meier survival analysis and Cox regression.

Results: Of 374 patients in the PERSTEMI-II study, 366 (97.

[Clinical variables associated with no-reflow after percutaneous coronary intervention in ST-segment elevation myocardial infarction: Secondary analysis of the PERSTEMI I and II study].

Objective: To determine the clinical factors associated to no-reflow after percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction (STEMI) in Peru.

Materials And Methods: Case - control retrospective study, derived from the PERSTEMI (Peruvian Registry of ST-elevation myocardial infarction) I and II study. Cases (group 1) were those patients who presented no-reflow after PCI, defined by a TIMI flow < 3, and controls (group 2) were those with a TIMI 3 flow after the intervention.

Outcomes in ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention or pharmacoinvasive strategy in a Latin American country.

Objective: The primary percutaneous coronary intervention (PPCI) is the preferred reperfusion strategy for ST-segment elevation myocardial infarction (STEMI). The pharmacoinvasive strategy (PIs) is a reasonable alternative when prompt PPCI is not possible, especially in resource-limited regions. We aimed to compare PPCI versus PIs outcomes in Peru.

[Impact of the COVID-19 pandemic on ST - elevation myocardial infarction management in a reference center of northern Peru].

Objective: To evaluate the impact of the COVID-19 pandemic on the ST-Elevation myocardial infarction (STEMI) management in a reference center of northern Peru.

Methods: Observational, analytical, retrospective cohort-type study, derivated from the Acute Coronary Syndrome registry of the Almanzor Aguinaga Asenjo National Hospital. The characteristics of the patients with STEMI and their 30-day outcomes were compared in 02 cohorts according to the time of medical care: prior to the pandemic or during the pandemic.

[Treatment of acute myocardial infarction in Peru and its relationship with in-hospital adverse events: results from the second peruvian registry of ST-segment elevation myocardial infarction (PERSTEMI-II).].

Background: ST-segment elevation myocardial infarction (STEMI), is an important cause of morbidity and mortality worldwide, and myocardial reperfusion, when adequate, reduces the complications of this entity. The aim of the study was to describe the clinical and treatment characteristics of STEMI in Peru and the relationship of successful reperfusion with in-hospital adverse events.

Materials And Methods: Prospective, multicenter cohort of STEMI patients attended during 2020 in public hospitals in Peru.

[Rupture of a sinus of valsalva aneurysm into the right atrium in the adult: a case report].

Rupture of a Valsalva aneurysm in the adult is extremely rare and is often complicated by acute heart failure. We present the case of a 39-year-old patient with a non-coronary sinus of Valsalva aneurysm complicated by rupture into the right atrium associated with severe aortic regurgitation and moderate tricuspid regurgitation. The treatment was surgical and was based on the repair with a pericardial patch over the aneurysm, aortic valve replacement, and tricuspid plasty.

Influenza and Pneumococcal Vaccination in Non-Infected Cardiometabolic Patients from the Americas during the COVID-19 Pandemic. A Sub-Analysis of the CorCOVID-LATAM Study.

Background: Influenza vaccination (IV) and Pneumococcus vaccination (PV) are recommended for patients with cardiometabolic diseases. This study aimed to evaluate the immunization rate of ambulatory cardiometabolic patients during the COVID-19 pandemic in the Americas.

Methods: Electronic surveys were collected from 13 Spanish speaking countries between 15 June and 15 July 2020.

[Should i treat a high risk chronic coronary syndrome invasively from the beginning? Yes, in most cases].

Chronic coronary syndrome (SCC) previously known as stable coronary disease, is the main cause of mortality in the world, and it is one of the most important in Peru. This pathology has a dynamic nature that results in different clinical scenarios that can be modified through various therapeutic options, one of which is coronary interventional treatment, mainly in patients with high ischemic risk defined as ischemia greater than 10% of the entire left ventricular mass. For this reason, we have analyzed the most relevant and current information available, concluding that the treatment of high ischemic risk´s chronic coronary syndrome, after an individual evaluation, would correspond to an invasive management from the beginning, although it would not impact on mortality or cardiovascular events, it would contribute to improve quality of life; also we should consider the incomplete availability of all the therapeutic options for the symptomatic management of this disease, the limited access to the management of acute cardiovascular events in our country, as well as the risk of adverse effects and drug interactions.

Transcatheter closure of paravalvular leaks: short- and medium-term outcomes.

Background: Paravalvular leak (PVL) is a frequent and important complication after surgical valvular replacement that can cause heart failure and hemolytic anemia and is associated with poor clinical outcomes. Surgical reoperation has been the standard treatment, but it is associated with high morbidity and mortality. Transcatheter closure is a therapeutic alternative.

[Impact of the COVID-19 pandemic on ST- elevation myocardial infarction care in Peru].

Purpose: To compare the number of admissions, clinical features and therapeutic outcomes of patients treated for acute ST-segment elevation myocardial infarction (STEMI), before and after the COVID-19 pandemic state of emergency in Peru.

Methods: Observational analytical study of retrospective cohorts, derivated from the PEruvian Registry of ST-segment Elevation Myocardial Infarction II (PERSTEMI II). We compared the patients treated for STEMI, between 45 days before and during the first 45 days of the COVID-19 state of emergency in Peru.

Transcatheter closure of paravalvular leaks: short and medium-term outcomes.

Background: Paravalvular leak is a frequent and important complication after surgical valvular replacement that can cause heart failure, hemolytic anemia and is associated with poor clinical outcomes. Surgical reoperation has been the standard treatment, but it is associated with high morbidity and mortality. Transcatheter closure is a therapeutic alternative.

[Deferred versus immediate stenting in patients with ST - segment elevation myocardial infarction and residual large thrombus burden reclassified in the culprit lesion].

Background: Reclassification of a large thrombus burden is an independent predictor of major adverse cardiac events and no-reflow in patients with ST- segment elevation myocardial infarction (STEMI). Patients with a greater residual thrombus burden have worse microvascular dysfunction and greater myocardial damage.

Methods: A retrospective analysis was performed on 833 STEMI patients who underwent primary percutaneous coronary intervention.