Factores asociados al síndrome de Wellens en pacientes con síndrome coronario agudo sin elevación del segmento ST / Factors associated to Wellens' syndrome in patients with acute coronary syndrome without ST-segment elevation

Introducción: El síndrome de Wellens constituye un equivalente del síndrome coronario agudo con elevación del segmento ST. Este incluye dos patrones electrocardiográficos que sugieren lesión crítica de la arteria descendente anterior. Objetivo: Evaluar probables factores asociados al síndrome de Wellens en pacientes con síndrome coronario agudo sin elevación del segmento ST y lesiones coronarias significativas en la arteria descendente anterior. Material y métodos: Se realizó un estudio observacional, analítico, transversal en pacientes con diagnóstico de síndrome coronario agudo sin elevación del ST y lesión significativa en la arteria descendente anterior, comprobada mediante coronariografía, ingresados en la unidad de cuidados coronarios intensivos del Hospital Clínico-Quirúrgico Manuel Fajardo entre el 2016 y 2019. Resultados: La edad media fue de 66 años, predominó el sexo masculino (53,9 por ciento) y el antecedente de hipertensión arterial (89,5 por ciento). Los pacientes con síndrome de Wellens tuvieron un significativo menor porcentaje de antecedente de cardiopatía isquémica (58,1 por ciento vs. 84,8 por ciento; p = 0,012). Además, el síndrome arrojó asociación estadísticamente muy significativa con la condición de fumador activo (51,2 por ciento vs. 15,2 por ciento; p < 0,01). No se encontró relación estadística significativa entre el síndrome de Wellens y el resultado angiográfico. Conclusiones: La presencia de los patrones electrocardiográficos del síndrome de Wellens se asocia con el hábito tabáquico en pacientes con síndrome coronario agudo sin elevación del segmento ST y lesiones coronarias en la arteria descendente anterior, y su ausencia se asocia con el antecedente de cardiopatía isquémica en el mismo subgrupo de individuos(AU)

Introduction: Wellens' syndrome is equivalent to acute coronary syndrome with ST-segment elevation. It includes two electrocardiographic patterns suggesting a critical lesion in the anterior descending artery. Objective: Evaluate probable factors associated to Wellens' syndrome in patients with acute coronary syndrome without ST-segment elevation and significant coronary lesions in the anterior descending artery. Methods: A cross-sectional observational analytical study was conducted of patients diagnosed with acute coronary syndrome without ST-segment elevation and significant lesion in the anterior descending artery verified by coronary arteriography, admitted to the intensive coronary care unit at Manuel Fajardo Clinical Surgical Hospital in the period 2016-2019. Results: Mean age was 66 years, with a predominance of the male sex (53.9 percent) and a history of hypertension (89.5 percent). Patients with Wellens' syndrome had a significantly lower percentage of ischemic heart disease antecedents (58.1 percent vs. 84.8 percent; p = 0.012). A very significant statistical association was observed between the syndrome and active smoking (51.2 percent vs. 15.2 percent; p < 0.01). A significant statistical relationship was not found between Wellens' syndrome and angiographic results. Conclusions: The presence of electrocardiographic patterns of Wellens' syndrome is associated to smoking in patients with acute coronary syndrome without ST-segment elevation and coronary lesions in the anterior descending artery, whereas their absence is associated to a history of ischemic heart disease in the same subgroup of individuals(AU)

Diferencias sexuales en el síndrome coronario agudo. Hospital Comandante Manuel Fajardo, 2016-2017 / Gender differences in acute coronary syndrome. "Comandante Manuel Fajardo" Hospital, 2016-2017

Introducción: Existen diferencias tanto biológicas como socioculturales en las afecciones cardiovasculares. Las desigualdades en el pronóstico entre mujeres y hombres se deben a diversas variables, entre las que se encuentran factores de riesgo específicos de las féminas, discrepancias en las estrategias de tratamiento y diferencias fisiopatológicas. Objetivo: Identificar diferencias sexuales en pacientes que presentan un síndrome coronario agudo. Métodos: Se realizó un estudio observacional, analítico, de corte transversal, sobre diferencias de sexo en 170 pacientes con diagnóstico de síndrome coronario agudo egresados vivos de la Unidad de Cuidados Coronarios Intensivos del Hospital Clínico-Quirúrgico Comandante Manuel Fajardo en 2016 y 2017. Resultados: Las féminas tuvieron asociación estadísticamente muy significativa con una media de edad mayor (68 vs. 62 p < 0,01) y con el antecedente de hipertensión arterial (91,2% vs. 72,3% p < 0,01). El hábito tabáquico mostró asociación estadísticamente significativa con los individuos varones (50,5 vs. 30,4% p = 0,017). El sexo masculino tuvo una mediana de creatinina muy significativamente mayor (90 μmol/L vs. 80 μmol/L p < 0,01). Las mujeres mostraron un mayor riesgo de complicaciones hemodinámicas (OR = 3,11 IC 95% = 1,20-8,04). Conclusiones: En individuos con síndrome coronario agudo el sexo femenino se asocia con mayor edad, antecedente de hipertensión arterial y aparición de complicaciones hemodinámicas intrahospitalarias. Los varones se asocian con el hábito tabáquico y mayores concentraciones de creatinina sérica

Introduction: There are both biological and sociocultural differences in patients with cardiovascular diseases. Inequalities in the prognosis between women and men are due to several variables, including specific risk factors for females, discrepancies in treatment strategies, and pathophysiological differences. Objective: To identify gender differences in patients with acute coronary syndrome. Methods: An observational, analytical, cross-sectional study was carried out on the gender differences in 170 patients with a diagnosis of acute coronary syndrome who were discharged from the Intensive Coronary Care Unit of the Comandante Manuel Fajardo Clinical-Surgical hospital in 2016 and 2017. Results: Females had a statistically very significant association, with a higher mean age (68 vs. 62, P < .01) and with a history of arterial hypertension (91.2 vs. 72.3% P < .01). The smoking habit showed a statistically significant association with male individuals (50.5 vs. 30.4% P = .017). Males had a significantly higher median creatinine (90 μmol/L vs. 80 μmol/L, P < .01). Women showed an increased risk of haemodynamic complications (OR = 3.11, 95% CI = 1.20-8.04). Conclusions: In women with acute coronary syndrome, being female is associated with older age, a history of arterial hypertension, and the appearance of haemodynamic complications during admission. Males are associated with smoking habits and higher concentrations of serum creatinine

Gender differences in acute coronary syndrome. "Comandante Manuel Fajardo" Hospital, 2016-2017. / Diferencias sexuales en el síndrome coronario agudo. Hospital Comandante Manuel Fajardo, 2016-2017.

INTRODUCTION: There are both biological and sociocultural differences in patients with cardiovascular diseases. Inequalities in the prognosis between women and men are due to several variables, including specific risk factors for females, discrepancies in treatment strategies, and pathophysiological differences. OBJECTIVE: To identify gender differences in patients with acute coronary syndrome. METHODS: An observational, analytical, cross-sectional study was carried out on the gender differences in 170 patients with a diagnosis of acute coronary syndrome who were discharged from the Intensive Coronary Care Unit of the Comandante Manuel Fajardo Clinical-Surgical Hospital in 2016 and 2017. RESULTS: Females had a statistically very significant association, with a higher mean age (68 vs. 62, P<.01) and with a history of arterial hypertension (91.2 vs. 72.3% P<.01). The smoking habit showed a statistically significant association with male individuals (50.5 vs. 30.4% P=.017). Males had a significantly higher median creatinine (90µmol/L vs. 80µmol/L, P<.01). Women showed an increased risk of haemodynamic complications (OR=3.11, 95% CI=1.20-8.04). CONCLUSIONS: In women with acute coronary syndrome, being female is associated with older age, a history of arterial hypertension, and the appearance of haemodynamic complications during admission. Males are associated with smoking habits and higher concentrations of serum creatinine.