P575Merging technologies to provide Mexico an innovative nationwide AMI management network

Background

“Cόdigo Infarto”, the vast patient-centric, app-based, educational crusade of the Mexican Society of Interventional Cardiology (SOCIME) has been combined with the Latin America Telemedicine Infarct Network (LATIN) to create a comprehensive, national AMI program for Mexico.

Purpose

To demonstrate the benefits of amalgamating educational initiatives of national cardiology societies with a global telemedicine program for improving AMI management.

Methods

“Cόdigo Infarto” App connects patients to a network of several hundred cardiologists and 250 Primary PCI-capable labs. LATIN provides the partnership with its robust telemedicine platform, a hub-spoke strategy that supports patient's access to appropriate medical management. Remotely located experts, in Colombia, provide urgent EKG diagnosis via tele-consultation to the entire LATIN Mexico network. They activate ambulance dispatch and implement guideline-based protocols.

Results

Numerous “Cόdigo Infarto” sites have incorporated LATIN to provide a simple and accelerated management of AMI patients. Currently, the partnership (7 hubs, 78 spokes) has screened 19,886 patients. A total of 359 STEMI cases (1.8%) have been diagnosed; 118 patients (33%) were urgently reperfused, Primary PCI was performed in 74% of the latter cases. D2B time was 41 min. Reasons for the lack of treatment include delayed presentation, lack of ICU beds and insurance denials. Currently, these constraints are being methodically probed. Updated results will be available at time of presentation.

Conclusions

The synergy of the AMI initiative for Mexico provides a template for similar initiatives in developing countries.

[Discordant pattern, visual identification of myocardial viability with PET]

PET (positron emission tomography) as a non-invasive imaging method for studying cardiac perfusion and metabolism has turned into the gold standard for detecting myocardial viability. The utilization of 18 FDG as a tracer for its identification permits to spot the use of exogenous glucose by the myocardium segments. By studying and comparing viability and perfusion results, for which the latter uses tracers such as 13N-ammonia, three different patterns for myocardial viability evaluation arise:. transmural concordant pattern, non-transmural concordant pattern, and the discordant pattern; the last one exemplifies the hibernating myocardium and proves the presence of myocardial viability. The importance of its detection is fundamental for the study of an ischemic patient, since it permits the establishment of and exact diagnosis, prognosis, and the best treatment option. It also allows foreseeing functional recovery of the affected region as well as the ejection fraction rate after revascularization treatment if this is determined as necessary. All these elements regarding viability are determinant in order to reduce adverse events and help improving patients' prognosis.

[Effect to the serotonin transporter gene (5-HTT) on personality dimensions in individuals without psychopathology]

INTRODUCTION

The aim of the present study was to assess the association between the serotonin transporter gene and the Temperament and Character Inventory (TCI) personality dimensions in subjects without psychopathology.

METHOD

Fifty seven individuals without psychiatric symptoms were assessed with the SCL-90, and the TCI. In all subjects a peripheral blood sample was taken to determine their genotypes, after informed consent. Three groups were formed according to the 5-HTT genotype: SS, SL and LL, and the TCI results were compared.

RESULTS

There was no association among the 5-HTT genotypes and any of the TCI subscales. There were also no statistical differences among any of the three groups divided by genotype only according to the TCI scores, as well as when compared with historical controls.

CONCLUSIONS

These results are consistent with other studies that have not found associations among the different measurements of personality and 5-HTT genotypes. Likewise, our data suggest that our sample can be useful as a source of controls for later studies. This is the first study assessing TCI dimensions and the 5-HTT gene in the Mexican population.