ABSTRACT
Atrial fibrillation (AF) is the most common arrhythmia in adults. Prevention of the ischaemic risk with oral anticoagulants (OACs) is widely recommended, and current clinical guidelines recommend direct oral anticoagulants (DOACs) as preference therapy for stroke prevention. However, there are currently no clinical practice guidelines or recommendation documents on the optimal management of OACs in patients with AF that specifically address and adapt to the Central American and Caribbean context. The aim of this Delphi-like study is to respond to doubts that may arise in the management of OACs in patients with non-valvular AF in this geographical area. A consensus project was performed on the basis of a systematic review of the literature, a recommended ADOLOPMENT-like approach, and the application of a two-round Delphi survey. In the first round, 31 recommendations were evaluated and 30 reached consensus, of which, 10 unanimously agreed. The study assessed expert opinions in a wide variety of contextualized recommendations for the optimal management of DOACs in patients with non-valvular atrial fibrillation (NVAF). There is a broad consensus on the clinical practice guideline (CPG) statements used related to anticoagulation indication, patient follow-up, anticoagulation therapy complications, COVID-19 management and prevention, and cardiac interventions.
ABSTRACT
Introducción. La hipercolesterolemia familiar (HcF) es una patología causada por diversas mutaciones con una incidencia variable dependiendo de su forma heterocigota u homocigota. Sin embargo, pocos casos son diagnosticados y no todo el personal de salud conoce sobre la enfermedad.Materiales y Método. Se realizóuna encuesta en línea basada en Google Forms para medir el nivel de conocimiento del personal de salud sobre la HcF en la República Dominicana. Se utilizó un cuestionario confeccionado por los autores basado enlos criterios DUCTH de hipercolesterolemia.Resultados.El predominio del personal de salud que llenó el cuestionario fue de nutriólogos; el conocimiento sobre los valores de corte adecuado para el diagnóstico de HcF fue reportado en 30% de la muestra.Conclusiones. Es imperativo incrementar el conocimiento del personal de salud sobre HcF con el objetivo de disminuir la muerte cardiovascular prematura.
Introduction: Familial hypercholesterolemia (FH) is a disease caused by various mutations with a variable incidence depending on its heterozygous or homozygous form. However, few cases are diagnosed and not all health personnel know about the disease. Material and Methods: An online survey based on Google Forms was conducted to measure the level of knowledge of health personnel about FH in the Dominican Republic. A questionnaire prepared by the authors based on the DUCTH criteria for hypercholesterolemia was used. Results: The predominance of health personnel who filled out the questionnaire was nutritionists; knowledge about the appropriate cut-off values for the diagnosis of FH was reported in 30% of the sample. Conclusions: It is imperative to increase knowledge of the health personnel on FH to reduce premature cardiovascular death.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Cholesterol , Hyperlipoproteinemia Type II , KnowledgeABSTRACT
Introducción: La salud cardiovascular comprende un conjunto de variables que interactúan entre sí (entre factores no modificables y factores modificables) para modificar el riesgo de padecer un evento cardiovascular (EVC). Material y Métodos: Se realizóuna encuesta en línea basada en Google Forms para medir la salud cardiovascular en la población adulta en la República Dominicana. Se utilizó un cuestionario confeccionado por los autores basado en los criterios DUCTH de hipercolesterolemia. Resultados: Las características sociodemográficas de los participantes fueron heterogéneas, 60% de los participantes tenía antecedente familiar patológico, 55% reportó inactividad física, las prácticas dietéticas de nuestra muestra no fueron apropiadas, observando que 70% no ingería oingería pocas veces yogur, patrón observado en el 44% con respecto a la ingesta de leche, sin embargo, el 94% ingería con frecuencia carne. Conclusión: La salud cardiovascular de los dominicanos posee una menor calidad asociada a un mayor consumo de carnes y tabaco y menor cantidad de ejercicio; dicho comportamiento puede haber estado influido por la pandemia del COVID-19 o las características de la región.
Introduction:Cardiovascular health comprises a set of variables that interact with each other (between non-modifiable factors and modifiable factors) to modify the risk of sufferinga cardiovascular event (CVD). Material and Methods: An online survey based on Google Forms was conducted to measure cardiovascular health in the adult population in the Dominican Republic. A questionnaire prepared by the authors based on the DUCTH criteria for hypercholesterolemia was used. Results: The sociodemographic characteristics of the participants were heterogeneous, 60% of the participants had a pathological family history, 55% were physical inactive, observing 70% had no or minimum intake of yogurt, same behavior was observed in 44% of the sample related to milk intake, yet 94% had a frequent intake of meat. Conclusion: The cardiovascular health of Dominicans has a lower quality associated with a higher consumption of meat and tobacco and a lower amount of exercise; This behavior may have been influenced by the COVID-19 pandemic or the characteristics of the region.
