Santos PA, Valero HA

Language: Spanish
References: 22
Page: 161-168
PDF size: 476.06 Kb.

ABSTRACT

Introduction: The advent of new invasive coronary intervention strategies has led to a worldwide reduction in morbidity and in-hospital mortality from acute coronary syndrome. However, these indicators have had some variations in the Provincial Department of Cardiology of Sancti Spiritus.
Objective: To determine the clinical and epidemiological factors associated with inhospital course of patients admitted with this diagnosis.
Method: An observational, descriptive, and retrospective research was carried out at the Department of Cardiology at "Camilo Cienfuegos" General Provincial Hospital in 2011. The sample consisted of 363 patients admitted with some clinical forms of acute ischemic heart disease. The frequency distribution according to clinical and epidemiological variables were calculated by statistical significance tests (Chi square, logistic regression, beta exponential), which allowed to establish relations with the different variables and mortality.
Results: The most frequent complications were: acute left ventricular dysfunction, ventricular arrhythmias and post-infarction angina. Prior topography infarction, history of previous infarction, hypertension and smoking were the variables that related the most with mechanical complications and recurrent stroke. The longest demurrage was motivated by postinfarction angina, reinfarction and cardiogenic shock.
Conclusions: There was a decrease in hospital mortality from acute coronary syndrome in 2011 although there was a high incidence of mechanical and arrhythmic complications which motivated a longer stay at the Department of Cardiology.

REFERENCES

1. Hamm CW, Bassand JP, Agewall S, Bax J, Boersma E, Bueno H, et al. Guía de práctica clínica de la ESC para el manejo del síndrome coronario agudo en pacientes sin elevación persistente del segmento ST. Rev Esp Cardiol. 2012;65:173.e1-e55.

2. Tubaro M, Danchin N, Goldstein P, Filippatos G, Ha-sin Y, Heras M, et al. Tratamiento prehospitalario de los pacientes con IAMCEST. Una declaración científica del Working Group Acute Cardiac Care de la European Society of Cardiology. Rev Esp Cardiol. 2012;65:60-70.

3. Lloyd-Jones D, Adams R, Carnethon M, De Simone G, Ferguson TB, Flegal K, et al. Heart disease and stroke statistics – 2009 update: A report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation. 2009;119:e21-181.

4. Nuñez J, Sanchis J, Núñez E, Bodí V, Mainar L, Miña-na G, et al. Insuficiencia cardiaca aguda post-alta hospitalaria tras un síndrome coronario agudo sin elevación del segmento-ST y riesgo de muerte e infarto agudo de miocardio subsiguiente. Rev Esp Cardiol. 2010;63:1035-44.

5. Fox KA, Carruthers KF, Dunbar DR, Graham C, Man-ning JR, De Raedt H, et al. Underestimated and under-recognized: the late consequences of acute coronary syndrome (GRACE UK-Belgian Study). Eur Heart J. 2010;31:2755-64.

6. Mancia G, Fagard R, Narkiewicz K, Redón J, Zan-chetti A, Böhm M, et al. 2013 ESH/ESC Guidelines for the management of arterial hypertension: the Task Force for the management of arterial hyper-tension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens. 2013;31:1281-357.

7. Mirzaei M,Truswell AS, Taylor R, Leeder SR. Coro-nary heart disease epidemics: not all the same. Heart. 2009;95:740-6.

8. Stone GW, Maehara A, Lansky AJ, De Bruyne B, Cristea E, Mintz GS, et al. A prospective natural-history study of coronary atherosclerosis. N Engl J Med. 2011;364:226-35.

9. Rubiera R, Lara A, Ramos NI, Palacio H, Vignier D. Síndrome coronario agudo. Caracterización clínico epidemiológica. A propósito de nuestro primer año. Rev Cubana Med Intens Emergen [Internet]. 2009 [citado 12 Ago 2014];8:1450-61. Disponible en: http://www.bvs.sld.cu/revistas/mie/vol8_3_09/mie07309.htm

10. Mellado FJ, Rosell F, Ruiz M. Tratamiento extra-hospitalario del infarto agudo de miocardio en Andalucía. Rev Esp Cardiol. 2005;58:1287-93.

11. 11.Kuch B, von Scheidt W, Kling B, Ehmann A, Gres-chik C, Meisinger C. Are there options to prevent early occurring deaths in acute myocardial infarc-tion: Prospective evaluation of all <24 h in-hospital deaths, 2004-2006 – The MONICA/KORA Augsburg Infarction Registry. Cardiology. 2010;116:237-44.

12. 12.Strom M, Wan X, Poelzing S, Ficker E, Rosenbaum DS. Gap junction heterogeneity as mechanism for electrophysiologically distinct properties across the ventricular wall. Am J Physiol Heart Circ Physiol. 2010;298:H787-94.

13. 13.Morrow DA. Cardiovascular risk prediction in pa-tients with stable and unstable coronary heart dis-ease. Circulation. 2010;121:2681-91.

14. 14.León CA. Predicción de la muerte súbita cardíaca post infarto ¿Tenemos otros métodos para prede-cir la muerte súbita cardíaca post infarto agudo de miocardio, además de la fracción de eyección? Insuf Card. 2011;6:144-50.

15. 15.Ochoa LA, González M, Vilches E, Fernández-Britto JE, Araujo RE, en representación de la Sección de Investigación en Muerte Súbita de la Sociedad Cu-bana de Aterosclerosis. Muerte súbita cardiovascu-lar en poblaciones de riesgo. CorSalud [Internet]. 2014 [citado 20 Sep 2014];6:S71-8. Disponible en: http://www.corsalud.sld.cu/suplementos/2014/v6s1a14/pob-riesgo.html

16. 16.Vigo J. Muerte súbita cardíaca: La importancia de la desfibrilación temprana y la resucitación cardio-pulmonar. CorSalud [Internet]. 2014 [citado 20 Sep 2014];6:S46-59. Disponible en: http://www.corsalud.sld.cu/suplementos/2014/v6s1a14/rcp.html

17. 17.Orta J. Protocolos de actuación para prevenir la muerte súbita. Experiencia cubana. CorSalud [In-ternet]. 2014 [citado 20 Sep 2014];6:S19 [Resu-men]. Disponible en: http://www.corsalud.sld.cu/suplementos/2014/v6s1a14/resumenes.html

18. 18.Cordero QM, Ramírez JI, Moreno-Martínez FL, González O. Valor predictivo de algunos modelos de estratificación de riesgo en pacientes con infarto agudo de miocardio con elevación del ST. CorSalud [Internet]. 2013 [citado 20 Sep 2014];5: 57-71. Disponible en: http://www.corsalud.sld.cu/sumario/2013/v5n1a13/estratificacion.html

19. 19.Serrano G, Pérez JM, del Pino E. Evolución clínica de pacientes con infarto agudo de miocardio tra-tados con angioplastia primaria. CorSalud [Inter-net]. 2012 [citado 20 Sep 2014];4:157-65. Disponi-ble en: http://www.corsalud.sld.cu/sumario/2012/v4n3a12/actp.html

20. 20.Lønborg J, Vejlstrup N, Kelbæk H, Nepper-Christen-sen L, Jørgensen E, Helqvist S, et al. Impact of acute hyperglycemia on myocardial infarct size, area at risk, and salvage in patients with STEMI and the association with exenatide treatment: Results from a randomized study. Diabetes. 2014;63:2474-85.

21. 21.León-Aliz E, Moreno-Martínez FL, Pérez-Fernández GA, Vega-Fleites LF, Rabassa-López-Calleja MA. Índice leuco-glucémico como marcador pronóstico de la evolución intrahospitalaria en pacientes con infarto agudo de miocardio con elevación del ST. Clin Invest Arterioscl. 2014;26:167-74.

22. 22.Fernández A, Gálvez AM, Castillo A. Costo institu-cional del infarto agudo del miocardio en el Insti-tuto de Cardiología y Cirugía Cardiovascular. Rev Cubana Salud Pública [Internet]. 2008 [citado 23 Sep 2014];34:[aprox. 8 p.]. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0864-34662008000400006