RESUMO
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.
RESUMO
Presentamos el caso de un síndrome coronario agudo en un paciente de 30 años con trombocitemia esencial. Los síndromes coronarios agudos ocurren en el 9% de los casos en estos pacientes, y su manejo constituye todo un reto para el cardiólogo, en concreto, en cuanto a la elección del tratamiento antiagregante más adecuado y su duración, considerando que estos pacientes tienen por una parte un elevado riesgo trombótico y, además, un riesgo hemorrágico no despreciable
We present the case is presented of an acute coronary syndrome in a 30-year-old patient with essential thrombocythaemia. Acute coronary syndromes occur in 9% of cases in these patients, and their management constitutes a challenge for the cardiologist, specifically in terms of choosing the most appropriate antiplatelet therapy and its duration, taking into account that these patients have a high thrombotic risk, as well as a considerable haemorrhagic risk
Assuntos
Humanos , Masculino , Adulto , Síndrome Coronariana Aguda/etiologia , Trombocitemia Essencial/complicações , Inibidores da Agregação Plaquetária/administração & dosagem , Síndrome Coronariana Aguda/terapia , Dor no Peito/etiologia , Ecocardiografia , Cateterismo Cardíaco , Trombocitemia Essencial/diagnósticoRESUMO
We present the case is presented of an acute coronary syndrome in a 30-year-old patient with essential thrombocythaemia. Acute coronary syndromes occur in 9% of cases in these patients, and their management constitutes a challenge for the cardiologist, specifically in terms of choosing the most appropriate antiplatelet therapy and its duration, taking into account that these patients have a high thrombotic risk, as well as a considerable haemorrhagic risk.
Assuntos
Síndrome Coronariana Aguda/diagnóstico , Inibidores da Agregação Plaquetária/administração & dosagem , Trombocitemia Essencial/diagnóstico , Síndrome Coronariana Aguda/tratamento farmacológico , Síndrome Coronariana Aguda/etiologia , Adulto , Humanos , Masculino , Inibidores da Agregação Plaquetária/efeitos adversos , Trombocitemia Essencial/complicações , Trombocitemia Essencial/tratamento farmacológico , Trombose/etiologia , Trombose/prevenção & controleRESUMO
OBJECTIVES: To determine the degree of risk factor control, the clinical symptoms and the therapeutic management of patients with a history of previous myocardial infarction. METHODS: Cross-sectional study at 6â years of a first episode of acute myocardial infarction between 2000 and 2009, admitted at a hospital in the region of Extremadura (Spain). Of 2177 patients with this diagnosis, 1365 remained alive and therefore were included in the study. RESULTS: We conducted a person-to-person survey in 666 (48.8%) individuals and telephone survey in 437 (31.9%) individuals. The former are analysed. 130 were female (19.5%). The mean age was 67.4â years and the median time since the event was 5.8 (IQR 3.6-8.2) years. Active smokers made up 13.8%, low-density lipoprotein (LDL) cholesterol was ≥70â mg/dL: 82%, blood pressure ≥140/90â mmâ Hg (≥140/85 in diabetics): 49.8%, fasting glucose ≥126â mg/dL: 26%, heart rate 50-59â bpm: 60.7%, and obesity: 45.9%. Patients reported presenting angina comprised 22.4% and those with dyspnoea, 29.3%. Drug coverage was: 88.0% antiplatelet drugs, 86.5% statins, 75.6% ß-blockers and 65.8% blockers of the renin-angiotensin system. Patients receiving all four types of drugs made up 41.9%, with only 3.0% having jointly controlled cholesterol, blood pressure, heart rate and glycaemia. CONCLUSIONS: LDL cholesterol, heart rate and blood pressure were risk factors with less control. More than 1/5 of patients had angina and more than 1/4, dyspnoea. Risk factor control and the clinical condition were far from optimal, as was drug coverage, although to a lesser degree.
RESUMO
No disponible
Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Sarcoma do Estroma Endometrial/patologia , Neoplasias Cardíacas/patologia , Embolia Pulmonar/etiologia , Histerectomia , Anticoagulantes/uso terapêuticoRESUMO
No disponible
Assuntos
Humanos , Enfisema Mediastínico/etiologia , Volvo Gástrico/complicações , Hérnia Hiatal/complicações , Ruptura Gástrica/etiologia , Fatores de RiscoAssuntos
Neoplasias do Endométrio/complicações , Átrios do Coração/patologia , Embolia Pulmonar/etiologia , Sarcoma do Estroma Endometrial/secundário , Trombose/etiologia , Neoplasias Vasculares/secundário , Anticoagulantes/uso terapêutico , Antineoplásicos Hormonais/uso terapêutico , Terapia Combinada , Neoplasias do Endométrio/patologia , Neoplasias do Endométrio/terapia , Enoxaparina/uso terapêutico , Feminino , Procedimentos Cirúrgicos em Ginecologia , Humanos , Veia Ilíaca/patologia , Excisão de Linfonodo , Pessoa de Meia-Idade , Terapia Neoadjuvante , Neoplasias Pélvicas/tratamento farmacológico , Neoplasias Pélvicas/radioterapia , Neoplasias Pélvicas/secundário , Embolia Pulmonar/tratamento farmacológico , Radioterapia Adjuvante , Sarcoma do Estroma Endometrial/complicações , Sarcoma do Estroma Endometrial/patologia , Sarcoma do Estroma Endometrial/terapia , Tamoxifeno/uso terapêutico , Trombose/tratamento farmacológico , Neoplasias Vasculares/complicações , Veia Cava Inferior/patologiaAssuntos
Transtornos Relacionados ao Uso de Cocaína/complicações , Diabetes Mellitus Tipo 1/complicações , Enfisema Mediastínico/etiologia , Pneumopericárdio/etiologia , Transtornos Relacionados ao Uso de Cocaína/fisiopatologia , Cetoacidose Diabética/etiologia , Emergências , Hidratação , Humanos , Insulina/uso terapêutico , Masculino , Enfisema Mediastínico/diagnóstico por imagem , Enfisema Mediastínico/fisiopatologia , Pneumopericárdio/diagnóstico por imagem , Pneumopericárdio/fisiopatologia , Pressão , Alvéolos Pulmonares/fisiopatologia , Ruptura Espontânea , Tórax , Tomografia Computadorizada por Raios X , Vômito/complicações , Vômito/fisiopatologia , Desequilíbrio Hidroeletrolítico/etiologia , Desequilíbrio Hidroeletrolítico/terapia , Adulto JovemRESUMO
No disponible
Assuntos
Humanos , Masculino , Idoso , Síndrome Coronariana Aguda/induzido quimicamente , Antineoplásicos/efeitos adversos , Cardiotoxinas , /complicaçõesRESUMO
No disponible