ABSTRACT
No disponible
Subject(s)
Humans , Cardiovascular Agents/therapeutic use , Cardiovascular Diseases/drug therapy , Diabetes Mellitus, Type 2/complications , Secondary Prevention/methods , Hypoglycemic Agents/therapeutic useABSTRACT
El control de los factores de riesgo cardiovascular (CV) es esencial en pacientes con enfermedad cardiovascular. La polipíldora CV contiene ácido acetilsalicílico 100 mg, atorvastatina 20 mg o 40 mg y ramipril 2,5 mg, 5 mg o 10 mg en combinación fija. El objetivo fue revisar las evidencias sobre la prevención secundaria de la enfermedad cardiovascular, establecer los posibles perfiles de pacientes donde usar la polipíldora CV con atorvastatina 40mg en prevención CV secundaria (P40PS) y definir las situaciones prioritarias de empleo de la P40PS. Se realizó una revisión bibliográfica, que se complementó con la opinión clínica de 19 especialistas. Durante la hospitalización y al alta, la P40PS es una opción en pacientes ingresados por un evento aterotrombótico de cualquier territorio, enfermedad arterial periférica u otras causas y con indicación de los monocomponentes. Se plantea su uso prioritario en: intolerancia previa a la dosis de atorvastatina 80 mg, edad > 75 años, bajo peso, insuficiencia renal crónica estadio 3, hipotiroidismo, interacciones farmacológicas y origen asiático. En el ámbito extrahospitalario, la P40PS es una alternativa terapéutica en los pacientes con necesidad de prevención CV secundaria con indicación para recibir los monocomponentes y las situaciones prioritarias son recibir los tres componentes por separado, requerir polimedicación, falta de adherencia o de comprensión del tratamiento, y falta de control de los factores de riesgo CV. Este trabajo es el primero con propuestas de uso de la P40PS y puede facilitar el tratamiento de los pacientes con enfermedad cardiovascular en prevención secundaria
Controlling cardiovascular risk factors (CV) is essential for patients with cardiovascular disease. The CV polypill contains aspirin 100 mg, atorvastatin 20 mg or 40 mg, and ramipril 2.5 mg, 5 mg or 10 mg in a fixed combination pill. The objective was to review the evidence on the secondary prevention of cardiovascular disease, to establish the eventual patient profiles suitables to consider the use of CV polypill with atorvastatin 40 mg in secondary CV prevention (P40PS), and to define the priority situations most adequate for the use of P40PS. A bibliographic review was carried out, which was complemented with the clinical opinion of 19 specialists. During hospitalization and discharge, P40PS is an option for patients admitted because of an atherothrombotic event, peripheral arterial disease, or other causes, and with the indication of the monocomponents. Its priority use is proposed in: prior intolerance to the highest dose of atorvastatin (80 mg), age > 75 years, low weight, stage 3 of chronic renal failure, hypothyroidism, drug interactions and Asian origin. Outside the hospital setting, the P40PS is a therapeutic alternative in patients with a need for secondary CV prevention and with indication to receive the monocomponents. The priority situations to receive the P40PS are: to be taking the three components separately, to require polypharmacy, lack of adherence or understanding of the treatment, and lack of control of CV risk factors. This work is the first with proposals for the use of P40PS and can facilitate the treatment of patients with cardiovascular disease in secondary prevention
Subject(s)
Humans , Male , Female , Aged , Aged, 80 and over , Cardiovascular Diseases/drug therapy , Secondary Prevention/methods , Cardiovascular Diseases/prevention & control , Cardiovascular Diseases/physiopathology , Atorvastatin/administration & dosage , Drug Therapy, Combination/methods , Atherosclerosis , Aspirin/administration & dosage , /therapeutic use , Prescriptions/standardsABSTRACT
Controlling cardiovascular risk factors (CV) is essential for patients with cardiovascular disease. The CV polypill contains aspirin 100mg, atorvastatin 20mg or 40mg, and ramipril 2.5mg, 5mg or 10mg in a fixed combination pill. The objective was to review the evidence on the secondary prevention of cardiovascular disease, to establish the eventual patient profiles suitables to consider the use of CV polypill with atorvastatin 40mg in secondary CV prevention (P40PS), and to define the priority situations most adequate for the use of P40PS. A bibliographic review was carried out, which was complemented with the clinical opinion of 19 specialists. During hospitalization and discharge, P40PS is an option for patients admitted because of an atherothrombotic event, peripheral arterial disease, or other causes, and with the indication of the monocomponents. Its priority use is proposed in: prior intolerance to the highest dose of atorvastatin (80mg), age>75 years, low weight, stage 3 of chronic renal failure, hypothyroidism, drug interactions and Asian origin. Outside the hospital setting, the P40PS is a therapeutic alternative in patients with a need for secondary CV prevention and with indication to receive the monocomponents. The priority situations to receive the P40PS are: to be taking the three components separately, to require polypharmacy, lack of adherence or understanding of the treatment, and lack of control of CV risk factors. This work is the first with proposals for the use of P40PS and can facilitate the treatment of patients with cardiovascular disease in secondary prevention.
Subject(s)
Aspirin/administration & dosage , Atorvastatin/administration & dosage , Cardiovascular Diseases/prevention & control , Ramipril/administration & dosage , Antihypertensive Agents/administration & dosage , Cardiovascular Diseases/etiology , Drug Combinations , Humans , Hydroxymethylglutaryl-CoA Reductase Inhibitors/administration & dosage , Medication Adherence , Platelet Aggregation Inhibitors/administration & dosage , Risk Factors , Secondary Prevention/methodsABSTRACT
No disponible
Subject(s)
Humans , Primary Health Care/organization & administration , Continuity of Patient Care/organization & administration , Atrial Fibrillation/epidemiology , Heart Failure/epidemiology , Health Care CostsABSTRACT
No disponible
Subject(s)
Humans , Diabetes Mellitus, Type 2/epidemiology , Heart Failure/epidemiology , Hypoglycemic Agents/adverse effects , Myocardial Infarction/prevention & controlSubject(s)
Cardiovascular Diseases , Diabetes Mellitus/epidemiology , Disease Management , Periodicals as Topic , Cardiovascular Diseases/epidemiology , Cardiovascular Diseases/etiology , Cardiovascular Diseases/prevention & control , Diabetes Mellitus/drug therapy , Global Health , Humans , Hypoglycemic Agents/therapeutic use , Prevalence , Randomized Controlled Trials as Topic , Survival Rate/trendsABSTRACT
Little information is available about the potential role of brain (type B) natriuretic peptide in patients with acute myocardial infarction. We therefore analyzed peptide levels, measured at discharge from our coronary care unit, in 56 patients admitted with a diagnosis of acute myocardial infarction. We examined peptide concentrations in the light of different features in our patients, and found a significant association between natriuretic peptide levels and the two most important prognostic factors: left ventricular ejection fraction, and the severity and extent of coronary disease. Type B natriuretic peptide was a good predictor of these features, and we conclude that concentration of type B natriuretic peptide, measured at discharge from the coronary care unit, provides important clinical and prognostic information in patients with acute myocardial infarction.