ABSTRACT
INTRODUCTION: Despite the use of the new generation P2Y12 inhibitors (Ticagrelor and Prasugrel) with aspirin is the recommended therapy in acute NSTE-ACS patients, their current use in clinical practice remains quite low and might be related, among several variables, with increased comorbidity burden. We aimed to assess the prevalence of these treatments and whether their use could be associated with comorbidity. METHOD: A multicentric prospective registry was conducted at 8 Cardiac Intensive Care Units (October 2017-April 2018) in patients admitted with non ST elevation myocardial infarction. Antithrombotic treatment was recorded and the comorbidity risk was assessed using the Charlson Comorbidity Index. We created a multivariate model to identify the independent predictors of the use of new inhibitors of P2Y12. RESULTS: A total of 629 patients were included, median age 67 years, 23.2% women, 359 patients (57.1%) treated with clopidogrel and 40.6% with new P2Y12 inhibitors: ticagrelor (228 patients, 36.2%) and prasugrel (30 patients, 4.8%). Among the patients with very high comorbidity (Charlson Score > 6) clopidogrel was the drug of choice (82.6%), meanwhile in patients with low comorbility (Charlson Score 0-1) was the ticagrelor or prasugrel (63.6%). Independent predictors of the use of ticagrelor or prasugrel were a low Charlson Comorbidity Index, a low CRUSADE score and the absence of prior bleeding. CONCLUSION: Antiplatelet treatment with Ticagrelor or Pasugrel was low in patients admitted with NSTE-ACS. Comorbidity calculated with Charlson Comorbidity Index was a powerful predictor of the use of new generation P2Y12 inhibitors in this population.
Subject(s)
Acute Coronary Syndrome , Percutaneous Coronary Intervention , Platelet Aggregation Inhibitors , Prasugrel Hydrochloride , Ticagrelor , Acute Coronary Syndrome/drug therapy , Acute Coronary Syndrome/epidemiology , Aged , Comorbidity , Female , Humans , Male , Platelet Aggregation Inhibitors/therapeutic use , Prasugrel Hydrochloride/therapeutic use , Ticagrelor/therapeutic use , Treatment OutcomeABSTRACT
No disponible
Subject(s)
Humans , Male , Young Adult , Electrocardiography/instrumentation , Electrocardiography/methods , Atrioventricular Node/pathology , Atrioventricular Node , Atrial Function/physiology , Heart Atria/pathology , Heart AtriaSubject(s)
Arrhythmias, Cardiac/diagnosis , Electrocardiography , Adolescent , Asymptomatic Diseases , Humans , MaleSubject(s)
Acute Coronary Syndrome/mortality , Angiotensin-Converting Enzyme Inhibitors/therapeutic use , Aspirin/therapeutic use , Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use , Acute Coronary Syndrome/drug therapy , Cause of Death/trends , Drug Therapy, Combination , Female , Follow-Up Studies , Humans , Male , Middle Aged , Retrospective Studies , Spain/epidemiology , Survival Rate/trends , Time FactorsABSTRACT
No disponible
Subject(s)
Humans , Male , Middle Aged , Pericardial Effusion/etiology , Myelodysplastic Syndromes/complications , Arthritis/etiology , Synovitis/etiology , Risk Factors , Edema/etiology , Shoulder Pain/etiology , Leukemia, Myeloid, Acute/diagnosisABSTRACT
Presentamos el hallazgo casual de una alteración electrocardiográfica compatible con ritmo auricular bajo en un reconocimiento médico para la aptitud deportiva de un paciente varón de 9 años. El ritmo auricular bajo es un ritmo ectópico que se puede encontrar en pacientes en edad pediátrica o deportistas. Se considera una variante de la normalidad pero debe realizarse un buen diagnóstico diferencial de patologías potencialmente graves
We present the incidental finding of an electrocardiographic alteration, compatible with low atrial rhythm, during the physical examination for a sport aptitude certificate in a 9 years-old boy. The low atrial rhythm is an ectopic rhythm that can be found in pediatric patients and athletes. It's considered as a variation of normality, but it is important to have a correct diagnostic to differentiate it from potentially serious pathologies
