RESUMO
No disponible
Assuntos
Humanos , Masculino , Idoso , Insuficiência Respiratória/terapia , Hematoma/diagnóstico por imagem , Hematoma/etiologia , Vértebras Cervicais/lesões , Catéteres/efeitos adversos , Miastenia Gravis/complicações , Insuficiência Respiratória/etiologia , Plasmaferese , Hematoma/cirurgia , Veias Jugulares/cirurgia , Veias Jugulares/lesões , Tomografia Computadorizada por Raios XRESUMO
No disponible
Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Hemoptise/etiologia , Cateterismo de Swan-Ganz/efeitos adversos , Embolização Terapêutica/métodos , Cateterismo de Swan-Ganz/instrumentação , Artéria Pulmonar/lesões , Ecocardiografia , Hemoptise/diagnóstico por imagem , Angiografia/instrumentaçãoRESUMO
No disponible
Assuntos
Humanos , Síndrome Coronariana Aguda/cirurgia , Intervenção Coronária Percutânea , Troponina/análise , Angiografia Coronária , Tratamento de Emergência/métodosRESUMO
OBJETIVO: Identificar los determinantes asociados a la estrategia invasiva precoz (EIP) en mujeres con síndrome coronario agudo sin elevación de ST (SCASEST). DISEÑO: Estudio de cohortes retrospectivo. Análisis crudo y ajustado de la realización de EIP mediante regresión logística no condicional. Ámbito: Unidades coronarias participantes en 2010-2011 en el registro ARIAM-SEMICYUC. PACIENTES: Cuatrocientas cuarenta mujeres con SCASEST. Se excluyeron 16 por datos insuficientes y 58 con coronariografía electiva (> 72 h). Variables analizadas: Demográficas, factores de riesgo coronario, medicación previa, comorbilidad. Características clínicas, analíticas, hemodinámicas y electrocardiográficas del episodio. RESULTADOS: Las mujeres tratadas conservadoramente presentaban mayor edad, mayor prevalencia de anticoagulación oral, diabetes, lesiones coronarias previas e insuficiencia cardiaca (p < 0,005), mayor riesgo hemorrágico e isquémico basal (p = 0,05) y mayor frecuencia cardiaca al ingreso (p < 0,05). Tras el ajuste solo la edad mayor de 80 años (OR: 0,48; IC 95%: 0,27-0,82; p = 0,009), las lesiones coronarias conocidas (OR: 0,47; IC 95%: 0,26-0,84, p = 0,011) y la frecuencia cardiaca (OR: 0,98; IC 95%: 0,97-0,99, p = 0,003) se asociaron de forma independiente al tratamiento conservador. El tabaquismo (OR: 2,50; IC 95%: 1,20-5,19; p = 0,013) y el electrocardiograma de alto riesgo (OR: 2,96; IC 95%: 1, 72-4,97; p < 0,001) se asociaron a la EIP. La exclusión de muertes precoces (< 24 h) no alteró estos resultados. CONCLUSIONES: En mujeres con SCASEST el tabaquismo y el electrocardiograma de alto riesgo al ingreso son factores independientes asociados a la EIP. Las lesiones coronarias previas conocidas, la edad > 80 años y el aumento de la frecuencia cardiaca son factores independientes asociados al tratamiento conservador
OBJECTIVE: To identify determinants associated to an early invasive strategy in women with acute coronary syndromes without ST elevation (NSTE-ACS). DESIGN: A retrospective cohort study was made. Crude and adjusted analysis of the performance of the early invasive strategy using logistic regression. SETTING: Coronary Units enrolled in 2010 - 2011 in the ARIAM-SEMICYUC registry. PATIENTS: A total of 440 women with NSTE-ACS were studied. Sixteen patients were excluded due to insufficient data, together with 58 patients subjected to elective coronary angiography (> 72h). Variables analyzed: Demographic parameters, coronary risk factors, previous medication, comorbidity. Clinical, laboratory, hemodynamic and electrocardiographic data of the episode. RESULTS: Women treated conservatively were of older age, had oral anticoagulation, diabetes, previous coronary lesions, and heart failure (p < 0,005), increased baseline bleeding and ischemic risk (p = 0,05) and a higher heart rate upon admission (p < 0,05). After adjustment, only age > 80 years (OR 0,48, 95% CI 0,27 to 0,82, p = 0,009), known coronary lesions (OR 0,47, 95% CI 0,26-0,84, p = 0,011), and heart rate (OR 0,98, 95% CI 0,97-0,99, p = 0,003) were independently associated to conservative treatment. Smoking (OR 2.50, 95% CI 1.20 to 5.19, p = 0,013) and high-risk electrocardiogram (OR 2.96, 95% CI 1.72 to 4.97, p < 0,001) were associated to the early invasive strategy. The exclusion of early deaths (<24h) did not alter these results. CONCLUSIONS: In women with NSTE ACS, smoking and a high-risk electrocardiogram upon admission were independent factors associated to the early invasive strategy. Previous coronary lesions, age > 80 years and increased heart rate were independent factors associated to conservative treatment
