by Xiao Gang. / Thesis (M.Sc.)--Chinese University of Hong Kong, 1998. / Includes bibliographical references (leaves 91-99). / Abstract also in Chinese. / ACKNOWLEDGEMENTS --- p.i / SUMMARY --- p.1 / Chapter 1 --- LITERATURE REVIEW / Chapter 1.1 --- MAGNESIUM --- p.3 / Chapter 1.1.1 --- GENERAL FUNCTION OF MAGNESIUM --- p.3 / Chapter 1.1.2 --- ABSORPTION AND METABOLISM OF MAGNESIUM --- p.6 / Chapter 1.1.3 --- CLINICAL ASPECTS --- p.8 / Chapter 1.1.4 --- METHODS OF DETERMINATION OF MAGNESIUM --- p.11 / Chapter 1.2 --- ZINC --- p.13 / Chapter 1.2.1 --- GENERAL FUNCTION OF ZINC --- p.13 / Chapter 1.2.2 --- ABSORPTION AND METABOLISM OF ZINC --- p.14 / Chapter 1.2.3 --- CLINICAL ASPECTS --- p.16 / Chapter 1.2.4 --- ASSESSMENT OF THE BODY ZINC STATUS --- p.19 / Chapter 1.2.5 --- METHODS OF DETERMINATION OF ZINC --- p.20 / Chapter 1.3 --- COPPER --- p.21 / Chapter 1.3.1 --- GENERAL FUNCTION OF COPPER --- p.21 / Chapter 1.3.2 --- ABSORPTION AND METABOLISM OF COPPER --- p.21 / Chapter 1.3.3 --- CLINICAL ASPECT --- p.25 / Chapter 1.3.4 --- LABORATORY ASSESSMENT OF COPPER STATUS --- p.28 / Chapter 1.3.5 --- METHODS FOR THE DETERMINATION OF COPPER --- p.29 / Chapter 1.4 --- SELENIUM --- p.31 / Chapter 1.4.1 --- GENERAL FUNCTION OF SELENIUM --- p.31 / Chapter 1.4.2 --- ABSORPTION AND METABOLISM OF SELENIUM --- p.31 / Chapter 1.4.3 --- CLINICAL ASPECTS --- p.34 / Chapter 1.4.4 --- ASSESSMENT --- p.36 / Chapter 1.4.5 --- METHODS OF DETERMINATION OF SELENIUM --- p.37 / Chapter 1.5 --- INTRODUCTION TO ATOMIC ABSORPTION SPECTROPHOTOMETRY --- p.38 / Chapter 1.5.1 --- PRINCIPLE OF AAS --- p.38 / Chapter 1.5.2 --- INSTRUMENTATION --- p.39 / Chapter 2 --- INTRODUCTION --- p.43 / Chapter 2.1 --- TRACE ELEMENT DEFICIENCY IN HOSPITAL PATIENT --- p.43 / Chapter 2.2 --- MICRONUTRIENT DEFICIENCY AMONG PATIENTS WITH ACUTE MYOCARDIAL INFARCTION --- p.44 / Chapter 2.2.1 --- MAGNESIUM DEFICIENCY --- p.44 / Chapter 2.2.2 --- CHANGE OF ZINC AND COPPER IN AMI --- p.47 / Chapter 2.2.3 --- SELENIUM DEFICIENCY --- p.50 / Chapter 2.3 --- OBJECTIVES OF THIS PROJECT --- p.52 / Chapter 3 --- MATERIALS AND METHODS / Chapter 3.1 --- PATIENTS SELECTION --- p.53 / Chapter 3.1.1 --- CONTROL GROUP --- p.53 / Chapter 3.1.2 --- AMI GROUP --- p.53 / Chapter 3.1.3 --- DIGOXIN TREATMENT GROUP --- p.54 / Chapter 3.2 --- ANALYTIC METHODS --- p.55 / Chapter 3.2.1 --- DETERMINATION OF SERUM Magnesium --- p.55 / Chapter 3.2.2 --- DETERMINATION OF SERUM ZINC --- p.57 / Chapter 3.2.3 --- DETERMINATION OF SERUM COPPER --- p.60 / Chapter 3.2.4 --- DETERMINATION OF SERUM SELENIUM --- p.63 / Chapter 4 --- RESULTS --- p.68 / Chapter 4.1 --- RESULTS OF EVALUATION OF ANALYTICAL --- p.68 / Chapter 4.1.1 --- RESULTS OF METHODS EVALUATION OF SERUM ZINC ASSAY --- p.68 / Chapter 4.1.2 --- RESULTS OF METHODS EVALUATION OF SERUM COPPER ASSAY --- p.71 / Chapter 4.1.3 --- RESULTS OF METHODS EVALUATION OF SERUM SELENIUM ASSAY --- p.73 / Chapter 4.2 --- RESULTS OF PATIENTS STUDY --- p.76 / Chapter 4.2.1 --- CONTROL GROUP --- p.76 / Chapter 4.2.2 --- PATIENTS WITH ACUTE MYOCARDIAL INFARCTION I DEMOGRAPHIC DATA --- p.77 / Chapter 4.2.3 --- DIGOXIN GROUP --- p.83 / Chapter 5 --- DISCUSSION --- p.85 / Chapter 5.1 --- AMI PATIENTS AND TRACE ELEMENT STATUS --- p.85 / Chapter 5.2 --- MAGNESIUM AND ZINC STATUS IN PATIENTS RECEIVING DIGOXIN TREATMENT --- p.88 / REFERENCE --- p.91 / LIST OF TABLES --- p.99 / LIST OF TABLES --- p.102 / TABLES & FIGURES

Introducción: La intervención coronaria percutánea primaria durante las 24 primeras horas de inicio del dolor torácico reduce la mortalidad por infarto de miocardio con ST elevado (IMA STE). El objetivo del estudio fue evaluar la mortalidad intrahospitalaria a 30 días según el tiempo puerta-balón y el tiempo total de isquemia en pacientes con IAM STE sometidos a intervención coronaria percutánea (ICP) primaria en un hospital de referencia. Métodos: Estudio retrospectivo de cohorte de pacientes con IMA STE sometidos a ICP primaria en un hospital de referencia de Lima, Perú. Analizamos la asociación entre el tiempo total de isquemia menor a 12 horas y tiempo puerta balón menor a 90 minutos con mortalidad a 30 días, mediante Regresión de Cox, ajustado por otros factores. Resultados: Durante el periodo 2010-2014, 296 sujetos con IMA STE fueron sometidos a ICP primaria. El 82,4% fueron varones y la media de edad fue 66,5 años ±11,8. La mortalidad intrahospitalaria a 30 días fue 8,11%. El 82,43% tuvo un tiempo total de isquemia menor a 12 horas y el 33,11% un tiempo puerta-balón menor a 90 minutos. No se encontró asociación entre ambos tiempos y mortalidad intrahospitalaria. El paro cardiaco (HR: 2,9 IC 95% 1,09-7,72), shock cardiogénico al ingreso (HR: 7,06 IC 95% 2,84-17,59) y un flujo TIMI menor a 3 post ICP (HR: 4,21 IC 95% 1,73-10,19) se asociaban a mayor mortalidad. Conclusión: No hubo asociación entre los tiempos estudiados con la mortalidad intrahospitalaria. Se sugieren intervenciones para disminuir los tiempos en esta población. / Introduction: Primary percutaneous coronary intervention reduces mortality in patients with ST elevated myocardial infarction (STE MI). The objective was to evaluate the 30 days in-hospital mortality according to door-to-balloon time and total ischemic time in patients treated with primary PCI. Methods: A retrospective cohort study was performed including patients with STE MI who underwent primary PCI at a national reference hospital in Lima, Peru. A Cox Regression analysis was performed for door-to-balloon time less than 90 minutes and total ischemic time less than 12 hours as predictors and in-hospital mortality as outcome. Results: During 2010’2014, 296 STE MI patients underewent PCI. From them, 82,4% were male. The mean age was 66,5 ±11,8 years. The 30-day mortality was 8,11%. The proportion of patients with total ischemic time less than 12 hours and door-to-balloon time was 82,43% and 33,11% respectively. No association between these intervals and 30-day mortality was found. Cardiac arrest (HR: 2,9 95%CI 1,09-7,72), cardiogenic shock at the admission (HR: 7,06; 95%CI: 2,84- 17,59) and TIMI flow less than 3 after primary PCI (HR: 4,21; 95%CI: 1,73-10,19) were associated with higher 30-day mortality.. Conclusion: No association between mortality and lower total ischemia time or door to ballon time mortality was found. A significant delay was observed in hospital arrival and performing revascularization.