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BACKGROUND: Low-density lipoprotein cholesterol (LDL-C) contributes decisively to the development of cardiovascular disease (CVD). In the LYNX registry we determined the rate of achievement of the target value of LDL-C, the use of lipid-lowering therapy (LLT) and the predictive factors of not reaching the target in patients with stable coronary heart disease (CHD). METHODS: LYNX included consecutive patients with stable CHD treated at the University Hospital of Caceres, Extremadura (Spain) from September 2016 to September 2018, and those who must have an LDL-C target below 70 mg/dL according to the European Society of Cardiology (ESC) 2016 guidelines. The variables independently associated with the breach of the LDL-C objective were evaluated by multivariable logistic regression. RESULTS: A total of 674 patients with stable CHD were included. The average LDL-C levels were 68.3 ± 24.5 mg/dL, with 56.7% showing a level below 70 mg/dL. LLT was used by 96.7% of patients, 71.7% were treated with high-powered statins and 30.1% with ezetimibe. The risk of not reaching the target value of LDL-C was higher in women, in active smokers, and in those who had multivessel CHD or had atrial fibrillation. Patients with diabetes mellitus, those who took potent statins or co-administration treatment with ezetimibe were more likely to reach the target level of LDL-C. CONCLUSIONS: The treatment of dyslipidemia in patients with chronic CHD remains suboptimal; however, an increasing number of very high-risk patients achieve the LDL-C objective, although there is still enormous potential to improve cardiovascular outcome through the use of more intensive LLT.
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Humanos , Masculino , Femenino , Adulto , Actinas/genética , Disección Aórtica/genética , Aneurisma de la Aorta Torácica/genética , ADN/genética , Mutación , Actinas/metabolismo , Disección Aórtica/metabolismo , Aneurisma de la Aorta Torácica/metabolismo , Análisis Mutacional de ADN , LinajeRESUMEN
Introducción y objetivo: Determinar el cambio en las características clínicas y pronósticas de pacientes ingresados por síndrome coronario agudo (SCA) durante un periodo de los años 2005 y 2015 en un hospital de referencia provincial. Material y método: Estudio observacional transversal que compara las características del SCA de los años 2005 y 2015. Se analizaron factores de riesgo cardiovascular, tratamientos al alta, complicaciones y mortalidad. Resultados: La incidencia de SCA en 2015 fue un 15,3% menor. La incidencia de hipertensión arterial, diabetes y dislipemia fue similar, pero hubo más fumadores en 2015 (25,9% vs 18,3%; p = 0,005). La reperfusión coronaria y la prescripción de tratamientos de prevención secundaria aumentaron respecto a 2005. La mortalidad hospitalaria fue similar. Conclusión: La incidencia de SCA ha disminuido en la última década en paralelo a una mejoría en el pronóstico relacionado con un uso más frecuente de los tratamientos recomendados en las guías
Introduction and objective: To determine the changes in the clinical and prognostic characteristics of patients admitted due to acute coronary syndrome (ACS) during the period between the years 2005 and 2015 in a provincial referral hospital. Material and method: Cross-sectional observational study was conducted comparing the characteristics of ACS between 2005 and 2015. An analysis was made of the cardiovascular risk factors, treatment at discharge, complications, and mortality. Results: The incidence of ACS in 2015 was 15.3% lower. The incidence of hypertension, diabetes and dyslipidaemia was similar, but there were more smokers in 2015 (25.9% vs 18.3%, P=.005). Coronary reperfusion and the prescription of secondary prevention treatments increased compared to 2005. Hospital mortality was similar. Conclusion: The incidence of ACS has decreased in the last decade, in parallel with an improvement in the prognosis related to a more frequent use of the treatments recommended in the guidelines
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Humanos , Masculino , Femenino , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Síndrome Coronario Agudo/mortalidad , Mortalidad Hospitalaria , Síndrome Coronario Agudo/terapia , Estudios Transversales , Factores de Riesgo , Pronóstico , Incidencia , España/epidemiologíaRESUMEN
INTRODUCTION AND OBJECTIVE: To determine the changes in the clinical and prognostic characteristics of patients admitted due to acute coronary syndrome (ACS) during the period between the years 2005 and 2015 in a provincial referral hospital. MATERIAL AND METHOD: Cross-sectional observational study was conducted comparing the characteristics of ACS between 2005 and 2015. An analysis was made of the cardiovascular risk factors, treatment at discharge, complications, and mortality. RESULTS: The incidence of ACS in 2015 was 15.3% lower. The incidence of hypertension, diabetes and dyslipidaemia was similar, but there were more smokers in 2015 (25.9% vs 18.3%, P=.005). Coronary reperfusion and the prescription of secondary prevention treatments increased compared to 2005. Hospital mortality was similar. CONCLUSION: The incidence of ACS has decreased in the last decade, in parallel with an improvement in the prognosis related to a more frequent use of the treatments recommended in the guidelines.
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Síndrome Coronario Agudo/epidemiología , Diabetes Mellitus/epidemiología , Dislipidemias/epidemiología , Hipertensión/epidemiología , Síndrome Coronario Agudo/mortalidad , Síndrome Coronario Agudo/fisiopatología , Anciano , Anciano de 80 o más Años , Estudios Transversales , Femenino , Factores de Riesgo de Enfermedad Cardiaca , Mortalidad Hospitalaria , Hospitalización , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Pronóstico , Prevención Secundaria , Fumar/epidemiologíaAsunto(s)
Actinas/genética , Aneurisma de la Aorta Torácica/genética , Disección Aórtica/genética , ADN/genética , Mutación , Actinas/metabolismo , Adulto , Disección Aórtica/metabolismo , Aneurisma de la Aorta Torácica/metabolismo , Análisis Mutacional de ADN , Femenino , Humanos , Masculino , LinajeRESUMEN
La existencia de una buena coordinación entre los distintos niveles asistenciales constituye un factor fundamental en el desarrollo de una asistencia sanitaria de calidad y eficiente. El médico de atención primaria es fundamental en la prevención secundaria de la enfermedad cardiovascular, y la estrecha colaboración entre atención primaria y cardiología constituye un factor clave en el control de la enfermedad cardiovascular. El proyecto CAPaCERES (Colaboración AP-Cardiología en Cáceres) pretende mejorar la coordinación entre atención primaria y cardiología desde la perspectiva del conocimiento mutuo y la mejora de la comunicación entre los profesionales que la desarrollan, y con ello a mejorar la calidad de la asistencia al paciente crónico con enfermedad cardiovascular
The existence of good coordination between the different levels of care is an essential factor in the development of quality and efficient healthcare. The primary care physician is fundamental in the secondary prevention of cardiovascular disease and the close collaboration between primary care and cardiology is a key factor in the control of cardiovascular disease. The CAPaCERES project (AP-Cardiology Collaboration in Cáceres) aims to improve the coordination between primary care and cardiology from the perspective of mutual knowledge and the improvement of communication between the professionals who develop it, and with that to improve the quality of care chronic patient with cardiovascular disease
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Humanos , Atención a la Salud , Atención Primaria de Salud , Enfermedades Cardiovasculares/prevención & control , Comunicación , Proyectos Piloto , Educación Continua , Prevención Secundaria , Prestación Integrada de Atención de Salud/métodosRESUMEN
The existence of good coordination between the different levels of care is an essential factor in the development of quality and efficient healthcare. The primary care physician is fundamental in the secondary prevention of cardiovascular disease and the close collaboration between primary care and cardiology is a key factor in the control of cardiovascular disease. The CAPaCERES project (AP-Cardiology Collaboration in Cáceres) aims to improve the coordination between primary care and cardiology from the perspective of mutual knowledge and the improvement of communication between the professionals who develop it, and with that to improve the quality of care chronic patient with cardiovascular disease.
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Enfermedades Cardiovasculares/prevención & control , Médicos de Atención Primaria/organización & administración , Atención Primaria de Salud/organización & administración , Cardiología/organización & administración , Comunicación , Conducta Cooperativa , Humanos , Relaciones Interprofesionales , Prevención Secundaria/métodosAsunto(s)
Dolor Agudo/etiología , Dolor en el Pecho/etiología , Necrosis Grasa/complicaciones , Pericardio/diagnóstico por imagen , Dolor Agudo/diagnóstico , Anciano , Dolor en el Pecho/diagnóstico , Diagnóstico Diferencial , Necrosis Grasa/diagnóstico , Femenino , Estudios de Seguimiento , Humanos , Tomografía Computarizada por Rayos XRESUMEN
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Humanos , Rotura Espontánea , Aneurisma Coronario/complicaciones , Infarto del Miocardio , Factores de Riesgo , Diagnóstico Diferencial , Angiografía CoronariaRESUMEN
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