{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T08:06:31Z","timestamp":1789459591092,"version":"build-2803163510"},"reference-count":27,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2013,3,14]],"date-time":"2013-03-14T00:00:00Z","timestamp":1363219200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2013,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Ischemic heart disease is a growing health problem in Latin America. We aimed to analyze risk factors, acute management, and short\u2010term outcome of Mexicans with <jats:styled-content style=\"fixed-case\">ST<\/jats:styled-content>\u2010elevation myocardial infarction (<jats:styled-content style=\"fixed-case\">STEMI<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Hypothesis<\/jats:title><jats:p>Modifiable risk factors are associated with the occurrence of STEMI in Mexicans, and potentially preventable acute complications are responsible for most short\u2010term deaths.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Among 8600 patients enrolled in Registro Nacional de los S\u00edndromes Coronarios Agudos <jats:styled-content style=\"fixed-case\">II<\/jats:styled-content> (<jats:styled-content style=\"fixed-case\">RENASICA II<\/jats:styled-content>) with a suspected acute coronary syndrome, we analyzed 4555 patients (56%; age 21\u2013100 y) with confirmed <jats:styled-content style=\"fixed-case\">STEMI<\/jats:styled-content> who presented within 24 hours from symptoms' onset.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Smoking (66%), hypertension (50%), and diabetes (43%) were the main risk factors. Most patients (74%) presented with Killip class I (class <jats:styled-content style=\"fixed-case\">IV<\/jats:styled-content> in 4%). Anterior\u2010located <jats:styled-content style=\"fixed-case\">STEMI<\/jats:styled-content> occurred in 56% of cases, and posterior\u2010inferior in 40% of cases. Significant Q waves were present in 43%, right bundle branch block in 7%, left bundle branch block in 5%, first\u2010degree atrioventricular block in 2%, and high\u2010degree atrioventricular block in 2%. A total of 1685 (37%) patients received fibrinolytic therapy (streptokinase, 82%; alteplase, 17%; tenecteplase, 1%), with 31% of patients receiving therapy in &lt;2 hours, 36% in 2\u20134 hours, 19% in 4\u20136 hours, and 15% in &gt;6 hours. Thirty percent of patients received either percutaneous coronary intervention or coronary artery bypass grafting during hospitalization. Major adverse cardiovascular events were recurrent ischemia (12%), reinfarction (4%), cardiogenic shock (4%), and stroke (1%). The main predictors of 30\u2010day mortality (10%) in multivariate analysis were age \u226565 years (odds ratio [<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>]: 2.47, 95% confidence interval [<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>]: 1.94\u20103.13), Killip class <jats:styled-content style=\"fixed-case\">IV<\/jats:styled-content> (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>: 10.60, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 6.09\u201018.40), and cardiogenic shock (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>: 18.76, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 10.60\u201033.20).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Largely modifiable risk factors and preventable short\u2010term complications are responsible for most <jats:styled-content style=\"fixed-case\">STEMI<\/jats:styled-content> cases and outcomes in this Mexican population.<\/jats:p><\/jats:sec>","DOI":"10.1002\/clc.22107","type":"journal-article","created":{"date-parts":[[2013,3,14]],"date-time":"2013-03-14T23:42:24Z","timestamp":1363304544000},"page":"241-248","source":"Crossref","is-referenced-by-count":20,"title":["Risk Factors, Therapeutic Approaches, and In\u2010Hospital Outcomes in Mexicans With <scp>ST<\/scp>\u2010Elevation Acute Myocardial Infarction: The <scp>RENASICA II<\/scp> Multicenter Registry"],"prefix":"10.1002","volume":"36","author":[{"given":"\u00darsulo","family":"Ju\u00e1rez\u2010Herrera","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos","family":"Jerjes\u2010S\u00e1nchez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"and The RENASICA II Investigators","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,3,14]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2003.10.009"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/clc.20873"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(96)07492-2"},{"key":"e_1_2_7_5_1","unstructured":"Health statistics: main causes of general mortality in Mexico 2008. 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