Perfil clínico de la mujer con cardiopatía isquémica estable en España. Son necesarios más esfuerzos en prevención secundaria. Estudio SIRENA / The clinical profile of women with stable ischaemic heart disease in Spain. More effort is needed in secondary prevention. SIRENA study

Objetivos. Las enfermedades cardiovasculares son la primera causa de muerte en mujeres, particularmente la cardiopatía isquémica, que aún se sigue considerando una enfermedad de hombres. En España hay diversos registros sobre cardiopatía isquémica, aunque ninguno exclusivo de mujeres. Los objetivos de SIRENA fueron describir el perfil clínico de las mujeres con cardiopatía isquémica atendidas en las consultas de cardiología, estimar su prevalencia de factores de riesgo cardiovascular y conocer su manejo clínico y tratamiento. Pacientes y métodos. Estudio multicéntrico, observacional, con una muestra de 631 mujeres con cardiopatía isquémica estable, incluidas consecutivamente en las consulta de cardiología. Participaron 41 investigadores de toda España. Resultados. La edad media fue de 68,5 años. La presentación clínica fue en forma de síndrome coronario agudo hasta en un 67,2%. La prevalencia de factores de riesgo cardiovascular fue elevada (77,7% hipertensión, 40,7% diabetes y 68% dislipidemia), con un 30,7% de hipertensión no controlada, un 78,4% con cifras de colesterol-LDL superiores a 70mg/dl y un 49,2% con HbA1c superior al 7%. La gran mayoría de las pacientes recibían tratamiento médico óptimo con antiagregantes, betabloqueantes, bloqueadores del eje renina-angiotensina-aldosterona e hipolipidemiantes. Se realizó coronariografía en el 88,3% de los casos e intervencionismo coronario percutáneo en el 63,4%. Conclusiones. La mujer con cardiopatía isquémica estable en España tiene una presentación clínica inicial con alguna forma de síndrome coronario agudo y una elevada prevalencia de factores de riesgo cardiovascular inadecuadamente controlados, pese a recibir terapia médica óptima. Un elevado porcentaje se somete a revascularización coronaria. Son precisos más esfuerzos en la prevención secundaria de las mujeres con cardiopatía isquémica estable (AU)

Objectives. Cardiovascular diseases are the leading cause of death for women, especially ischaemic heart disease, which is still considered a man's disease. In Spain, there are various registries on ischaemic heart disease, although none are exclusively for women. The objectives of the SIRENA study were to describe the clinical profile of women with ischaemic heart disease treated in cardiology consultations, to estimate its prevalence of cardiovascular risk factors and understand its clinical management. Patients and methods. A multicentre observational study was conducted with a sample of 631 women with stable ischaemic heart disease, consecutively included during cardiology consultations. Forty-one researchers from all over Spain participated in the study. Results. The mean age was 68.5 years. The clinical presentation was in the form of acute coronary syndrome in up to 67.2% of the patients. The prevalence of cardiovascular risk factors was high (77.7% of the patients had hypertension, 40.7% had diabetes and 68% had dyslipidaemia), with 30.7% having uncontrolled hypertension, 78.4% having LDL-cholesterol levels higher than 70mg/dL and 49.2% having HbA1c levels greater than 7%. The considerable majority of the patients underwent optimal medical treatment with antiplatelet agents, beta-blockers, renin-angiotensin-aldosterone system blockers and hypolipidaemic agents. Coronary angiography was performed for 88.3% of the patients, and 63.4% underwent percutaneous coronary intervention. Conclusions. Women with stable ischaemic heart disease in Spain initially present some form of acute coronary syndrome and a high prevalence of inadequately controlled cardiovascular risk factors, despite undergoing optimal medical therapy. A high percentage of these women undergo coronary revascularisation. Increased efforts are required for secondary prevention in women with stable ischaemic heart disease (AU)

[Catalogues of therapeutic nursing activities in neurological early rehabilitation]. / Leistungskataloge der aktivierend-therapeutischen Pflege in der neurologischen Frührehabilitation.

Under the German DRG-system, hospital-based rehabilitation of still critically ill patients becomes increasingly important. The code for early neurological rehabilitation in the DRG-system's (Diagnosis Related Groups) list of operations and procedures requires an average daily therapeutic intensity of 300 min, part of which is being contributed by therapeutic nursing. As therapeutic aspects are integrated in other nursing activities, it is difficult to separate its time consumption. This problem is pragmatically resolved by catalogues of therapeutic nursing activities which assign plausible amounts of therapeutic minutes to each activity. The 4 catalogues that are used most often are described and compared. Nursing science has not focused yet on therapeutic nursing.