RESUMEN
Objetivo Evaluar el uso de la terapia con beneficio cardiovascular en pacientes con DM tipo 2 previo al ingreso en servicios de medicina interna. Métodos Estudio transversal en un día de los pacientes con DM tipo 2 hospitalizados en servicios de medicina interna. Se recogieron variables demográficas y antropométricas, datos de laboratorio y utilización de fármacos antihiperglucemiantes. La variable desenlace fue la proporción y los determinantes de uso de inhibidores del cotransportador sodio-glucosa 2 (iSGLT2) y de agonistas del receptor del péptido similar al glucagón tipo 1 (AR-GLP1). Resultados Se incluyeron 928 pacientes pertenecientes a 74 hospitales. La edad media fue 78,9 años (DE: 10,86), un 50% varones. Un total de 557 (60%) presentaba cardiopatía isquémica, 189 (20,4%) enfermedad cerebrovascular, 293 (31,6%) insuficiencia cardiaca, 274 (29,5%) enfermedad renal crónica y 129 (13,9%) enfermedad arterial periférica. Los antihiperglucemiantes utilizados previo al ingreso fueron: sulfonilureas (5.7%), biguanidas (49.1%), inhibidores de la alfa-glucosidasa (0,2%), pioglitazona (0%), iDPP4 (39%), iSGLT2 (5,8%), AR-GLP1 (2,6%) y análogos de insulina basal (24%). La edad mayor de 75 años fue el factor determinante principal para no utilizar iSGLT2 (OR ajustada 0,28; intervalo de confianza al 95%: 0,10-0,74; p=0,039) o AR-GLP1 (OR ajustada 0,09; intervalo de confianza al 95%: 0,02-0,46; p=0,006). Discusión Una gran proporción de pacientes ancianos con DM tipo 2 de muy alto riesgo cardiovascular no recibe terapia antihiperglucemiante con fármacos de probado beneficio cardiovascular. El tratamiento más frecuentemente utilizado fue metformina e iDPP4. Existe un margen de mejora en el tratamiento en esta población de muy alto riesgo (AU)
Objective To evaluate the use of therapy with cardiovascular benefit in patients with type 2 diabetes mellitus admitted to internal medicine departments. Methods One day, cross-sectional study of patients with type 2 diabetes mellitus hospitalised in internal medicine departments. We recorded demographic and anthropometric variables, laboratory data and use of antihyperglycaemic drugs. The endpoint was the proportion and determinants of the use of sodium-glucose cotransporter-2 inhibitors (SGLT2i) and glucagon-like peptide-1 receptor agonists (GLP1-RA). Results We included 928 patients belonging to 74 hospitals, with a mean age of 78.9 years (SD, 10.86 years), 50% of whom were men. A total of 557 (60%) patients had ischaemic heart disease, 189 (20.4%) had cerebrovascular disease, 293 (31.6%) had heart failure, 274 (29.5%) had chronic kidney disease, and 129 (13.9%) had peripheral arterial disease. Prior to their hospital admission, the patients were taking sulfonylureas (5.7%), biguanides (49.1%), alpha-glucosidase inhibitors (0.2%), pioglitazone (0%), dipeptidyl peptidase 4 inhibitors (39%), SGLT2i (5.8%), GLP1-RA (2.6%) and basal insulin analogues (24%). An age over 75 years was the main determinant for not taking SGLT2i (adjusted OR, 0.28; 95% CI 0.10-0.74; P=.039) or GLP1-RA (adjusted OR, 0.09; 95% CI 0.02-0.46; P=.006). Discussion A large proportion of elderly patients with type 2 diabetes mellitus at very high cardiovascular risk are not treated with antihyperglycemic drugs with proven cardiovascular benefit. The most commonly used drugs were metformin and DPP4i. There is room for improvement in the treatment of this very high-risk population (AU)
Asunto(s)
Humanos , Masculino , Femenino , Anciano , Anciano de 80 o más Años , Inhibidores del Cotransportador de Sodio-Glucosa 2/administración & dosificación , Receptores de Péptidos Similares al Glucagón/agonistas , Diabetes Mellitus Tipo 2/tratamiento farmacológico , Hipoglucemiantes/administración & dosificación , Estudios Transversales , HospitalizaciónRESUMEN
OBJECTIVE: To evaluate the use of therapy with cardiovascular benefit in patients with type 2 diabetes mellitus admitted to internal medicine departments. METHODS: One day, cross-sectional study of patients with type 2 diabetes mellitus hospitalised in internal medicine departments. We recorded demographic and anthropometric variables, laboratory data and use of antihyperglycaemic drugs. The endpoint was the proportion and determinants of the use of sodium-glucose cotransporter-2 inhibitors (SGLT2i) and glucagon-like peptide-1 receptor agonists (GLP1-RA). RESULTS: We included 928 patients belonging to 74 hospitals, with a mean age of 78.9 years (SD, 10.86 years), 50% of whom were men. A total of 557 (60%) patients had ischaemic heart disease, 189 (20.4%) had cerebrovascular disease, 293 (31.6%) had heart failure, 274 (29.5%) had chronic kidney disease, and 129 (13.9%) had peripheral arterial disease. Prior to their hospital admission, the patients were taking sulfonylureas (5.7%), biguanides (49.1%), alpha-glucosidase inhibitors (0.2%), pioglitazone (0%), dipeptidyl peptidase 4 inhibitors (39%), SGLT2i (5.8%), GLP1-RA (2.6%) and basal insulin analogues (24%). An age over 75 years was the main determinant for not taking SGLT2i (adjusted OR, 0.28; 95% CI 0.10-0.74; pâ¯=â¯.039) or GLP1-RA (adjusted OR, 0.09; 95% CI 0.02-0.46; pâ¯=â¯.006). DISCUSSION: A large proportion of elderly patients with type 2 diabetes mellitus at very high cardiovascular risk are not treated with antihyperglycemic drugs with proven cardiovascular benefit. The most commonly used drugs were metformin and DPP4i. There is room for improvement in the treatment of this very high-risk population.
Asunto(s)
Enfermedades Cardiovasculares , Diabetes Mellitus Tipo 2 , Inhibidores del Cotransportador de Sodio-Glucosa 2 , Anciano , Enfermedades Cardiovasculares/epidemiología , Estudios Transversales , Diabetes Mellitus Tipo 2/tratamiento farmacológico , Hospitalización , Humanos , Hipoglucemiantes/uso terapéutico , Masculino , Inhibidores del Cotransportador de Sodio-Glucosa 2/uso terapéuticoRESUMEN
OBJECTIVE: To evaluate the use of therapy with cardiovascular benefit in patients with type 2 diabetes mellitus admitted to internal medicine departments. METHODS: One day, cross-sectional study of patients with type 2 diabetes mellitus hospitalised in internal medicine departments. We recorded demographic and anthropometric variables, laboratory data and use of antihyperglycaemic drugs. The endpoint was the proportion and determinants of the use of sodium-glucose cotransporter-2 inhibitors (SGLT2i) and glucagon-like peptide-1 receptor agonists (GLP1-RA). RESULTS: We included 928 patients belonging to 74 hospitals, with a mean age of 78.9 years (SD, 10.86 years), 50% of whom were men. A total of 557 (60%) patients had ischaemic heart disease, 189 (20.4%) had cerebrovascular disease, 293 (31.6%) had heart failure, 274 (29.5%) had chronic kidney disease, and 129 (13.9%) had peripheral arterial disease. Prior to their hospital admission, the patients were taking sulfonylureas (5.7%), biguanides (49.1%), alpha-glucosidase inhibitors (0.2%), pioglitazone (0%), dipeptidyl peptidase 4 inhibitors (39%), SGLT2i (5.8%), GLP1-RA (2.6%) and basal insulin analogues (24%). An age over 75 years was the main determinant for not taking SGLT2i (adjusted OR, 0.28; 95% CI 0.10-0.74; P=.039) or GLP1-RA (adjusted OR, 0.09; 95% CI 0.02-0.46; P=.006). DISCUSSION: A large proportion of elderly patients with type 2 diabetes mellitus at very high cardiovascular risk are not treated with antihyperglycemic drugs with proven cardiovascular benefit. The most commonly used drugs were metformin and DPP4i. There is room for improvement in the treatment of this very high-risk population.
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Enfermedad de Crohn/diagnóstico , Fístula Cutánea/diagnóstico , Fístula Rectal/diagnóstico , Colonoscopía , Enfermedad de Crohn/tratamiento farmacológico , Fístula Cutánea/terapia , Humanos , Inmunosupresores/uso terapéutico , Fístula Rectal/terapia , Recurrencia , Tomografía Computarizada por Rayos X , Resultado del TratamientoRESUMEN
No disponible
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Humanos , Inmunosupresores , Resultado del Tratamiento , Tomografía Computarizada por Rayos X , Fístula Rectal , Fístula Cutánea , Enfermedad de Crohn , Colonoscopía , RecurrenciaAsunto(s)
Eritropoyetina/sangre , Lupus Eritematoso Sistémico/complicaciones , Lupus Eritematoso Sistémico/diagnóstico , Aplasia Pura de Células Rojas/etiología , Enfermedad Aguda , Adulto , Anticuerpos/sangre , Diagnóstico Diferencial , Eritropoyetina/inmunología , Femenino , Humanos , Lupus Eritematoso Sistémico/sangre , Aplasia Pura de Células Rojas/sangreAsunto(s)
Linfoma de Burkitt/diagnóstico , Infecciones por VIH/complicaciones , Neoplasias Pancreáticas/diagnóstico , Pancreatitis Aguda Necrotizante/diagnóstico , Adulto , Linfoma de Burkitt/complicaciones , Linfoma de Burkitt/diagnóstico por imagen , Humanos , Masculino , Neoplasias Pancreáticas/complicaciones , Neoplasias Pancreáticas/diagnóstico por imagen , Pancreatitis Aguda Necrotizante/complicaciones , Tomografía Computarizada por Rayos XAsunto(s)
Agranulocitosis/tratamiento farmacológico , Antiinflamatorios no Esteroideos/efectos adversos , Factor Estimulante de Colonias de Granulocitos/uso terapéutico , Piroxicam/análogos & derivados , Anciano , Anciano de 80 o más Años , Agranulocitosis/inducido químicamente , Humanos , Masculino , Piroxicam/efectos adversosRESUMEN
5-fluorouracil is potentially cardiotoxic to man. To date, 47 patients have been reported with undesired heart disorders after the administration of this cytotoxic drug. The incidence of cardiotoxicity due to 5-FU is 1.6%. Angina-type precordial pain with electrocardiographic changes suggesting myocardial ischemia is the common clinical feature. Generally it disappears spontaneously or after the use of coronary vasodilators. Acute left ventricular failure, pericarditis and rythm disorders are not often found. The pathogenesis is unknown however, cardiac spasm as well as the direct or indirect effect of the drug on myocardium, are possible responsible mechanisms.