Evidence map›Paper›PMID 36578915›Full record

Observational studyGlobal heart2022

Structure, Process, and Mortality Associated with Acute Coronary Syndrome Management in Guatemala's National Healthcare System: The ACS-GT Registry.

José Antonio Cornejo-Guerra, Magda Isabel Ramos-Castro, Mariana Gil-Salazar, Sofia Leal-Wittkowsky, Juan Carlos Santis-Mejía, Elisa María Anleu-De León, Oscar Fernando Castro-Alvarado, Boris Rudy Alexander López-Quiñónez, Edgar Alexander Illescas-González, Paola Overall-Salazar and 7 more

Open access · goldAbstract readMulticenter StudyObservational Study
In one paragraph

Observational study in Global heart, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.3field-weighted citation impact, top 37% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 2 citations in OpenAlex.

  1. Article
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors at 4 institutions in 6 countries.

José Antonio Cornejo-GuerraUniversidad de San Carlos de Guatemala, Guatemala.ORCID 0000-0001-9919-819X
Magda Isabel Ramos-CastroUniversidad de San Carlos de Guatemala, Guatemala.ORCID 0000-0002-6188-8344
Mariana Gil-SalazarUniversidad de San Carlos de Guatemala, Guatemala.ORCID 0000-0002-5297-0151
Sofia Leal-WittkowskyUniversidad Francisco Marroquín, Guatemala.ORCID 0000-0002-5801-7900
Juan Carlos Santis-MejíaUniversidad de San Carlos de Guatemala, Guatemala.ORCID 0000-0001-9524-1170
Elisa María Anleu-De LeónUniversidad de San Carlos de Guatemala, Guatemala.ORCID 0000-0001-5749-445X
Oscar Fernando Castro-AlvaradoUniversidad de San Carlos de Guatemala, Guatemala.
Boris Rudy Alexander López-QuiñónezUniversidad de San Carlos de Guatemala, Guatemala.ORCID 0000-0003-2614-4654
Edgar Alexander Illescas-GonzálezUniversidad de San Carlos de Guatemala, Guatemala.
Paola Overall-SalazarInternal Medicine Department. Hospital General San Juan de Dios, Guatemala.
Luis Antonio Rodríguez-CifuentesUniversidad de San Carlos de Guatemala, Guatemala.
Karla Yesenia Miranda-SandovalUniversidad de San Carlos de Guatemala, Guatemala.ORCID 0000-0002-5278-8237
Juan Pablo PinedaUniversidad de San Carlos de Guatemala, Guatemala.ORCID 0000-0002-4944-4724
Kevin Oneal Flores-AndradeUniversidad de San Carlos de Guatemala, Guatemala.
Roberto Antonio Pérez-ReyesUniversidad Francisco Marroquín, Guatemala.ORCID 0000-0003-4417-2579
Sofía Waleska Girón-BlasUniversidad de San Carlos de Guatemala, Guatemala.
Josué Fernando Samayoa-RuanoUniversidad de San Carlos de Guatemala, Guatemala.ORCID 0000-0003-4374-0183
Universidad de San Carlos de Guatemala · GTHôpital régional · CHHospital General San Juan de Dios · GTUniversidad Francisco Marroquín · GT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Acute coronary syndromes (ACS) include ST-segment elevation myocardial infarction (STEMI), non-ST-segment elevation myocardial infarction (NSTEMI), and unstable angina (UA). The leading cause of mortality in Guatemala is acute myocardial infarction (AMI) and there is no established national policy nor current standard of care. Objective: Describe the factors that influence ACS outcome, evaluating the national healthcare system's quality of care based on the Donabedian health model. Methods: The ACS-Gt study is an observational, multicentre, and prospective national registry. A total of 109 ACS adult patients admitted at six hospitals from Guatemala's National Healthcare System were included. These represent six out of the country's eight geographic regions. Data enrolment took place from February 2020 to January 2021. Data was assessed using chi-square test, Student's t-test, or Mann-Whitney U test, whichever applied. A p-value < 0.05 was considered statistically significant. Results: One hundred and nine patients met inclusion criteria (80.7% STEMI, 19.3% NSTEMI/UA). The population was predominantly male, (68%) hypertensive (49.5%), and diabetic (45.9%). Fifty-nine percent of STEMI patients received fibrinolysis (alteplase 65.4%) and none for primary Percutaneous Coronary Intervention (pPCI). Reperfusion success rate was 65%, and none were taken to PCI afterwards in the recommended time period (2-24 hours). Prognostic delays in STEMI were significantly prolonged in comparison with European guidelines goals. Optimal in-hospital medical therapy was 8.3%, and in-hospital mortality was 20.4%. Conclusions: There is poor access to ACS pharmacological treatment, low reperfusion rate, and no primary, urgent, or rescue PCI available. No patient fulfilled the recommended time period between successful fibrinolysis and PCI. Resources are limited and inefficiently used.

Indexed as

Acute Coronary SyndromeMyocardial InfarctionNon-ST Elevated Myocardial InfarctionPercutaneous Coronary InterventionST Elevation Myocardial InfarctionAdultAngina, UnstableDelivery of Health CareFemaleGuatemalaHumansMaleProspective StudiesRegistriesTreatment Outcomeacute coronary syndromefibrinolysisGuatemalanon-ST elevated myocardial infarctionpercutaneous coronary interventionST elevation myocardial infarction

Identifiers

PMID36578915
PMCPMC9717345
OpenAlexW4312323563

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.