ABSTRACT
Presentamos el caso de un síndrome coronario agudo en un paciente de 30 años con trombocitemia esencial. Los síndromes coronarios agudos ocurren en el 9% de los casos en estos pacientes, y su manejo constituye todo un reto para el cardiólogo, en concreto, en cuanto a la elección del tratamiento antiagregante más adecuado y su duración, considerando que estos pacientes tienen por una parte un elevado riesgo trombótico y, además, un riesgo hemorrágico no despreciable
We present the case is presented of an acute coronary syndrome in a 30-year-old patient with essential thrombocythaemia. Acute coronary syndromes occur in 9% of cases in these patients, and their management constitutes a challenge for the cardiologist, specifically in terms of choosing the most appropriate antiplatelet therapy and its duration, taking into account that these patients have a high thrombotic risk, as well as a considerable haemorrhagic risk
Subject(s)
Humans , Male , Adult , Acute Coronary Syndrome/etiology , Thrombocythemia, Essential/complications , Platelet Aggregation Inhibitors/administration & dosage , Acute Coronary Syndrome/therapy , Chest Pain/etiology , Echocardiography , Cardiac Catheterization , Thrombocythemia, Essential/diagnosisABSTRACT
We present the case is presented of an acute coronary syndrome in a 30-year-old patient with essential thrombocythaemia. Acute coronary syndromes occur in 9% of cases in these patients, and their management constitutes a challenge for the cardiologist, specifically in terms of choosing the most appropriate antiplatelet therapy and its duration, taking into account that these patients have a high thrombotic risk, as well as a considerable haemorrhagic risk.
Subject(s)
Acute Coronary Syndrome/diagnosis , Platelet Aggregation Inhibitors/administration & dosage , Thrombocythemia, Essential/diagnosis , Acute Coronary Syndrome/drug therapy , Acute Coronary Syndrome/etiology , Adult , Humans , Male , Platelet Aggregation Inhibitors/adverse effects , Thrombocythemia, Essential/complications , Thrombocythemia, Essential/drug therapy , Thrombosis/etiology , Thrombosis/prevention & controlABSTRACT
Introducción y objetivos: En pacientes con enfermedad coronaria las guías establecen como objetivo un colesterol asociado a lipoproteínas de baja densidad (cLDL) <70mg/dl. A pesar de las evidencias del beneficio de un estricto control lipídico, el grado de consecución de objetivos es alarmantemente bajo en los estudios más recientes. Hemos analizado el grado de cumplimiento de objetivos lipídicos en pacientes coronarios de nuestra área sanitaria. Métodos: Estudio observacional y transversal realizado en el Área de Salud de Cáceres (España). Se incluyeron 741 pacientes coronarios ingresados entre 2009-2015 con un perfil lipídico en los últimos 3 años. Se analizaron: colesterol total, cLDL, colesterol asociado a lipoproteínas de alta densidad (cHDL), triglicéridos (TG) y colesterol-no-HDL. Resultados: El 74,4% eran varones. La edad media fue de 68,5±13,1 años: 76,3 ± 11,8 en las mujeres y 65,8 ± 12,6 en los varones (p < 0,001). El 52,3% tenían un cLDL < 70 mg/dl, sin diferencias entre sexos; estaban en objetivos el 44,8% de los pacientes < 55 años frente al 59,3% de los > 75 años. Tenían un cHDL > 40 mg/dl el 68,2% de los varones y un cHDL > 50 mg/dl el 54,8% de las mujeres. Mostraron unos TG < 150 mg/dl el 79,4%, sin diferencias entre sexos, y un colesterol-no-HDL< 100 mg/dl el 59,8%. Conclusiones: La mitad de pacientes coronarios no alcanzan los objetivos de control lipídico, y esta proporción es muy inferior a la comunicada en estudios previos. No existen diferencias en el cumplimiento de objetivos por sexos, y la edad es un predictor de cumplimiento
Introduction and objectives: Current guidelines recommend a low-density lipoprotein cholesterol (LDLc) target of < 70 mg/dl for patients with coronary artery disease. Despite the well-established benefits of strict lipid control, the most recent studies show that control rate of lipid targets are alarmingly low. An analysis was performed on the lipid targets attained according to current guidelines for the prevention of cardiovascular disease in coronary patients in a Caceres healthcare area. Methods: An observational and cross-sectional study was carried out in a healthcare area in Caceres (Spain). The study included a total of 741 patients admitted for coronary disease between 2009 and 2015 with available lipid profile in the last 3 years Total cholesterol, high-density lipoprotein cholesterol (LDLc), high-density lipoprotein cholesterol (HDLc), triglycerides (TG) and non-HDLc were analysed. Results: The majority (74.4%) of patients were male, with a mean age of 68.5±13.1 years; 76.3 ± 11.8 for women and 65.8 ± 12.6 for men (P < .001). A total of 52.3% patients achieved the LDLc target of < 70 mg/dl, with no gender differences. Only 44.8% of the patients < 55 years achieved their lipid targets, compared to 59.3% of the patients > 75 years. About 68.2% of men had an HDLc > 40 mg/dl, and 54.8% of women had an HDLc > 50 mg/dl. Overall, 79.4% of patients had a TG < 150 mg/dl, with no gender differences, and 59.8% had a non-HDLc < 100 mg/dl. Conclusions: Approximately one half of patients with coronary disease do not achieve their target lipid levels as defined in the European guidelines, and this rate is less than reported in previous studies. There are no gender differences in achieving lipid goals, and age is a predictor of adherence (AU)
Subject(s)
Humans , Coronary Disease/physiopathology , Dyslipidemias/epidemiology , Cholesterol/blood , Cholesterol, HDL/blood , Cholesterol, LDL/blood , Triglycerides/blood , 50293 , Risk FactorsABSTRACT
INTRODUCTION AND OBJECTIVES: Current guidelines recommend a low-density lipoprotein cholesterol (LDLc) target of <70mg/dl for patients with coronary artery disease. Despite the well-established benefits of strict lipid control, the most recent studies show that control rate of lipid targets are alarmingly low. An analysis was performed on the lipid targets attained according to current guidelines for the prevention of cardiovascular disease in coronary patients in a Caceres healthcare area. METHODS: An observational and cross-sectional study was carried out in a healthcare area in Caceres (Spain). The study included a total of 741 patients admitted for coronary disease between 2009 and 2015 with available lipid profile in the last 3 years Total cholesterol, high-density lipoprotein cholesterol (LDLc), high-density lipoprotein cholesterol (HDLc), triglycerides (TG) and non-HDLc were analysed. RESULTS: The majority (74.4%) of patients were male, with a mean age of 68.5±13.1 years; 76.3±11.8 for women and 65.8±12.6 for men (P<.001). A total of 52.3% patients achieved the LDLc target of <70mg/dl, with no gender differences. Only 44.8% of the patients <55 years achieved their lipid targets, compared to 59.3% of the patients >75 years. About 68.2% of men had an HDLc>40mg/dl, and 54.8% of women had an HDLc>50mg/dl. Overall, 79.4% of patients had a TG<150mg/dl, with no gender differences, and 59.8% had a non-HDLc<100mg/dl. CONCLUSIONS: Approximately one half of patients with coronary disease do not achieve their target lipid levels as defined in the European guidelines, and this rate is less than reported in previous studies. There are no gender differences in achieving lipid goals, and age is a predictor of adherence.
Subject(s)
Cardiovascular Diseases/prevention & control , Coronary Artery Disease/blood , Lipids/blood , Practice Guidelines as Topic , Age Factors , Aged , Aged, 80 and over , Cholesterol/blood , Cholesterol, HDL/blood , Cholesterol, LDL/blood , Cross-Sectional Studies , Female , Follow-Up Studies , Humans , Hypolipidemic Agents/administration & dosage , Male , Medication Adherence , Middle Aged , Risk Factors , Spain , Triglycerides/bloodABSTRACT
El uso de la radioterapia ha contribuido a mejorar la supervivencia de pacientes con diversos tumores malignos relacionados con la región torácica. No obstante, la irradiación cardíaca a una dosis suficientemente alta puede dañar prácticamente cualquier componente del mismo, incluyendo el sistema de conducción. Se describe el caso de un paciente que desarrolló bloqueo auriculoventricular completo, más de veinte años después de recibir radioterapia supradiafragmática para el tratamiento de un linfoma de Hodgkin.
The use of radiotherapy has contributed to improving the survival in patients with diverse malignancies related to the thoracic region. Nevertheless, cardiac radiation in sufficiently high dose can damage virtually any of its components, including the conduction system. We describe the case of a patient who developed a complete atrioventricular block more than twenty years after receiving supradiaphragmatic radiotherapy for Hodgkin lymphoma.
Subject(s)
Humans , Male , Adult , Heart Block , Atrioventricular Node , Biological Clocks , NeoplasmsABSTRACT
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