RESUMO
AIM: To analyze clinical profile and management of patients with nonvalvular atrial fibrillation treated with rivaroxaban in clinical practice according to age and to ascertain rates of thromboembolic and bleeding events during rivaroxaban therapy. METHODS: Retrospective study of nonvalvular atrial fibrillation patients that started rivaroxaban therapy between May 2013 and February 2017 in the cardiology department of two hospitals from Huesca, Spain. RESULTS: A total of 137 patients (mean age 78.2 ± 8.9 years; CHA2DS2-VASc 3.5 ± 1.3; HAS-BLED 1.6 ± 0.7) were included. Comorbidity was common. After a mean duration of treatment of 30.5 ± 17.2 months, no strokes were reported. Rates of transient ischemic attack, major bleeding and intracranial bleeding were low. CONCLUSION: In this cohort of elderly and highly comorbid patients treated with rivaroxaban, rates of thromboembolic and bleeding events were low.
Assuntos
Fibrilação Atrial/tratamento farmacológico , Inibidores do Fator Xa/uso terapêutico , Hemorragia/epidemiologia , Rivaroxabana/uso terapêutico , Acidente Vascular Cerebral/prevenção & controle , Tromboembolia/epidemiologia , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Fibrilação Atrial/complicações , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Padrões de Prática Médica , Estudos Retrospectivos , Espanha , Acidente Vascular Cerebral/etiologiaRESUMO
Intramyocardial dissecting hematoma is an infrequent complication of subacute myocardial infarction. Pathological findings consist of a cavity filled with blood, the outer wall of which is the myocardium and pericardium and the inner wall, which faces the ventricular cavity, is part of the myocardium and endocardium. There is scarce information on the subject and the management of these patients continues to be debated. However, there is a certain preference for surgical repair of the defect. Cases in which conservative treatment is a therapeutic option have been reported. We report the case of a patient with an intramyocardial dissecting hematoma after acute anterolateral myocardial infarction who was treated conservatively and achieved a satisfactory outcome in the intermediate-to-long term period.