Subject(s)
Cardiology , Heart Diseases , Follow-Up Studies , Humans , Primary Health Care , Referral and ConsultationABSTRACT
Pulmonary vein isolation is an effective treatment for patients with symptomatic paroxysmal atrial fibrillation. Cryoablation balloon therapy has been developed as an alternative. Cryoablation complications have primarily been related to phrenic nerve palsy, vascular complications, stroke, and others of lesser incidence. Esophageal lesions are rare and they are not yet completely understood.
Subject(s)
Catheter Ablation/adverse effects , Cryosurgery/adverse effects , Esophageal Diseases , Peptic Ulcer , Postoperative Complications/surgery , Pulmonary Veins/surgery , Adult , Esophageal Diseases/etiology , Esophageal Diseases/surgery , Female , Humans , Peptic Ulcer/etiology , Peptic Ulcer/surgeryABSTRACT
OBJECTIVES: To determine whether the risk of cardiovascular mortality associated with cardiorenal syndrome subtype 1 (CRS1) in patients who were hospitalized for acute coronary syndrome (ACS) was greater than the expected risk based on the sum of its components, to estimate the predictive value of CRS1, and to determine whether the severity of CRS1 worsens the prognosis. METHODS: Follow-up study of 1912 incident cases of ACS for 1 year after discharge. Cox regression models were estimated with time to event (in-hospital death, and readmission or death during the first year after discharge) as the dependent variable. RESULTS: The incidence of CRS1 was 9.2/1000 person-days of hospitalization (95% CI = 8.1-10.5), but these patients accounted for 56.6% (95% CI = 47.4-65.) of all mortality. The positive predictive value of CRS1 was 29.6% (95% CI = 23.9-36.0) for in-hospital death, and 51.4% (95% CI = 44.8-58.0) for readmission or death after discharge. The risk of in-hospital death from CRS1 (RR = 18.3; 95% CI = 6.3-53.2) was greater than the sum of risks associated with either acute heart failure (RR = 7.6; 95% CI = 1.8-31.8) or acute kidney injury (RR = 2.8; 95% CI = 0.9-8.8). The risk of events associated with CRS1 also increased with syndrome severity, reaching a RR of 10.6 (95% CI = 6.2-18.1) for in-hospital death at the highest severity level. CONCLUSIONS: The effect of CRS1 on in-hospital mortality is greater than the sum of the effects associated with each of its components, and it increases with the severity of the syndrome. CRS1 accounted for more than half of all mortality, and its positive predictive value approached 30% in-hospital and 50% after discharge.
Subject(s)
Acute Coronary Syndrome/complications , Cardio-Renal Syndrome/complications , Cardio-Renal Syndrome/epidemiology , Aged , Aged, 80 and over , Cardio-Renal Syndrome/diagnosis , Cardio-Renal Syndrome/mortality , Cause of Death , Comorbidity , Female , Follow-Up Studies , Heart Failure , Hospital Mortality , Hospitalization , Humans , Incidence , Kidney Function Tests , Male , Middle Aged , Mortality , Predictive Value of Tests , Proportional Hazards Models , Risk FactorsSubject(s)
Coronary Vessel Anomalies/diagnosis , Sinus of Valsalva/abnormalities , Chest Pain/etiology , Coronary Angiography , Coronary Vessel Anomalies/complications , Coronary Vessel Anomalies/diagnostic imaging , Coronary Vessel Anomalies/surgery , Diagnosis, Differential , Humans , Male , Middle Aged , StentsABSTRACT
Congenital anomalies of coronary arteries are a group of diseases that are infrequently found. Their prevalence has been reported from 0.6% to 1.3%. Most clinical manifestations are benign and asymptomatic. Congenital absence of the left circumflex artery is a very rare congenital anomaly of the coronary circulation, and only a few cases have been reported in the literature. We report a case of a 51-year-old man who underwent a cardiac catheterisation. Coronary angiography showed a left anterior descending coronary artery with no circumflex and a dominant right coronary artery.