Guías de actuación clínica de la Sociedad Española de Cardiología en el infarto agudo de miocardio

Arós, Fernando; Loma-Osorio, A; Alonso, Ángeles; Alonso, Joaquín; Cabadés, Adolfo; Coma-Canella, Isabel; Garcı́a-Castrillo, Luis; Garcı́a, Eulogio; Sá, Esteban López de; Pabón, Pedro; José, José M. San; Vera, Antonio; Worner, Fernando

doi:10.1016/s0300-8932(99)75024-4

Cited by 91 publications

(12 citation statements)

References 152 publications

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“…Despite the recommendations of the treatment guidelines, [2][3][4] it is interesting to note that 11.3% of the patients were not admitted to a CCU.…”

Section: Admission To a Ccu And Associated Variablesmentioning

confidence: 99%

“…1 The recommendations contained in the basic guidelines indicate that patients with AMI should be treated in a coronary care unit (CCU) or other hospital area with the capability for continuous electrocardiographic monitoring and defibrillation for at least the first 48 hours of the acute phase. [2][3][4] Furthermore, the relationship between coronary angiography usage in patients with AMI and mortality continues to be a subject for debate. [5][6][7][8][9] On-site availability of the technique leads to greater usage, 5,8,10 although its implementation is not always associated with lower mortality 5,7,8 but is probably associated with better quality of life.…”

Section: Introductionmentioning

confidence: 99%

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Hospital Resources and Myocardial Infarction Case Fatality. The IBERICA Study

Álvarez-León¹,

Elosúa²,

Zamora³

et al. 2004

Revista Española de Cardiología (English Edition)

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Introduction and objectives. To determine the proportion of patients with myocardial infarction (MI) not admitted to a coronary care unit (CCU), the variables associated with admission into a CCU, and whether admission to a CCU, and the availability of coronary angiography in the same hospital, were associated with 28-day case fatality. Patients and method. Population-based registry of MI in patients 25 to 74 years of age, admitted during 1996-1998. Demographic and clinical characteristics were recorded, as well as management, clinical course and survival after 28 days. Hospitals were classified according to the availability of a CCU and catheterization laboratory (advanced hospital), CCU only (intermediate hospital) or neither (basic hospital). Admission to the CCU was also recorded. Results. In all, 9046 cases of MI were recorded; in 11.3% the patient was not admitted to a CCU. Age, smoking (OR=1.33; 95% CI, 1.08-1.64), non-Q MI (OR=0.62; 95% CI, 0.49-0.78) or undetermined location of MI (OR=0.34; 95% CI, 0.23-0.50), Killip 4 score on admission (OR=0.63; 95% CI, 0.40-1.00) and delay in arrival at the hospital >6 h were associated with CCU admission. Patients admitted to a CCU showed a lower case fatality in the first 24 h (4.2% vs 23.5%), which was independent of comorbidity, severity and treatment. The 24-hour survivors admitted to a basic hospital had higher case fatality (17.3% vs 7.8%) than other groups, which was related to differences in treatment. Conclusions. CCU admission is associated with a lower case fatality in the first 24 h. Admission to a basic hospital is associated with a higher 28-day case fatality even in patients who survive 24 h. Resumen Introducción y objetivos. Determinar el porcentaje de pacientes con infarto agudo de miocardio (IAM) que no ingresan en una unidad de cuidados intensivos coronaries (UCIC), las variables asociadas al ingreso en una UCIC y si el ingreso en una UCIC, su disponibilidad y la de hemodinámica en el hospital se asocian a la letalidad a 28 días. Pacientes y método. Registro poblacional (1996-1998) de casos de IAM en pacientes con edades comprendidas entre los 25 y los 74 años. Se recogieron variables demográficas, clínicas, el ingreso en UCIC y la letalidad a los 28 días. Se clasificaron los hospitales según la disponibilidad de UCIC y hemodinámica (hospital avanzado), solamente UCIC (hospital intermedio) o ninguno (hospital básico). Resultados. Se registraron 9.046 casos; el 11,3% no ingresó en una UCIC. La edad, el consumo de tabaco (odds ratio [OR] = 1,33; intervalo de confianza [IC] del 95%, 1,08-1,64), el infarto sin onda Q (OR = 0,62; IC del 95%, 0,49-0,78) o ilocalizable (OR = 0,34; IC del 95%, 0,23-0,50), el grado Killip 4 al ingreso (OR = 0,63; IC del 95%, 0,40-1,00) y el retraso > 6 h en llegar al hospital se asociaron al ingreso en UCIC. Los pacientes ingresados en UCIC presentaban menor letalidad que los ingresados en hospitales básicos en las primeras 24 h (el 4,2 frente al 23,5%), independientemente de la gravedad del IAM y de las variables relaciona...

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“…Despite the recommendations of the treatment guidelines, [2][3][4] it is interesting to note that 11.3% of the patients were not admitted to a CCU.…”

Section: Admission To a Ccu And Associated Variablesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Hospital Resources and Myocardial Infarction Case Fatality. The IBERICA Study

Álvarez-León¹,

Elosúa²,

Zamora³

et al. 2004

Revista Española de Cardiología (English Edition)

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“…Data from published studies indicate that GLP-1 receptor agonists may be associated with a more substantial reduction in glycated hemoglobin (HbA1c) in comparison with DPP-4 inhibitors (0.5–1.6% reduction versus 0.5–1.0% reduction) [7]. Weight loss has been shown to be associated with liraglutide and exenatide treatment [9–14], whereas DPP-4 inhibitors are weight neutral and have been associated only with the prevention of weight gain [15–18]. …”

Section: Introductionmentioning

confidence: 99%

Incretin Therapy for Type 2 Diabetes in Spain: A Cost-Effectiveness Analysis of Liraglutide Versus Sitagliptin

Raya

Pérez

Arellano³

et al. 2013

Diabetes Ther

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IntroductionTreatment with glucagon-like peptide-1 receptor agonists and dipeptidyl peptidase-4 inhibitors, which target the incretin axis, has the potential to improve glycemic control in type 2 diabetes patients without the weight gain associated with traditional therapies. To evaluate the relative cost-effectiveness of incretin therapies, the present study aimed to compare the long-term clinical and cost implications associated with liraglutide and sitagliptin in type 2 diabetes patients in Spain.MethodsData were taken from a randomized, controlled trial (NCT00700817) in which adults with type 2 diabetes failing metformin monotherapy were randomly allocated to receive either liraglutide 1.2 mg or sitagliptin 100 mg daily in addition to metformin. Long-term projections of clinical outcomes and direct costs (2012 EUR) based on observed treatment effects were made using a published and validated type 2 diabetes model. Costs were taken from published sources. Future costs and clinical benefits were discounted at 3% annually. Sensitivity analyses were performed.ResultsLiraglutide was associated with improved discounted life expectancy (14.05 versus 13.91 years) and quality-adjusted life expectancy [9.04 versus 8.87 quality-adjusted life years (QALYs)] compared to sitagliptin. Improved clinical outcomes were driven by improved glycemic control, leading to reduced incidence of diabetes-related complications, including renal disease, cardiovascular disease, ophthalmic and diabetic foot complications. Liraglutide was associated with increased direct costs of EUR 2,297, yielding an incremental cost-effectiveness ratio of EUR 13,266 per QALY gained versus sitagliptin.ConclusionsLiraglutide was projected to improve life expectancy, quality-adjusted life expectancy and reduce incidence of diabetes-related complication. Liraglutide is likely to be cost-effective versus sitagliptin from a healthcare payer perspective in Spain.

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“…La respuesta a tal cuestionamiento parte de pensar que somos responsables del otro en la medida de su fragilidad o vulnerabilidad. Para desempeñar el cuidado, sea como actividad (lo realizamos todos los seres humanos para ayudar a la necesidad del otro), o como tarea profesional, debemos converger finalmente en un cuidado como actitud y como compromiso moral, ya que estamos ante personas que padecen enfermedades crónicas durante meses e inclusive años, con continuo deterioro, sorteando dificultades, sufrimientos y afectados en sus dimensiones física, social, psicológica, espiritual, tanto en condición de pacientes como de cuidadores (55,56).…”

Section: Discussionunclassified

Necesidad De Prácticas Cuidantes Culturalmente Congruentes: Personas Con Enfermedad Cardiovascular Al Final De La Vida

Cardona

Herrera²

2017

ECH

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El objetivo del estudio fue conocer las prácticas de cuidado que identifican los cuidadores familiares de personas con enfermedad cardiovascular al final de la vida. Se realizó una investigación cualitativa, que utilizó el método etnográfico particularista, en Medellín, Colombia, entre septiembre de 2014 y junio de 2015. Las participantes fueron mujeres cuidadoras familiares de personas con enfermedad cardiovascular en la etapa final de la vida. El estudio fue efectuado en tres escenarios de cuidado: domicilios, instituciones hospitalarias y centro geriátrico con unidad de cuidados paliativos. Con base en el análisis de los datos, emergió la categoría "Prácticas de Cuidado", que contiene cuatro subcategorías: a) Estar pendientes: insistir al paciente, brindar cuidados respiratorios, alimentarios, de hidratación, temperatura corporal, eliminación urinaria y fecal, movilidad y postura, cuidados de la piel, higiene y estéticos; b) Mitigar el dolor y el sufrimiento; c) Cuidados espirituales; y d) Cuidados paliativos. Del estudio se concluye que unas buenas prácticas cuidantes exigen conocimientos específicos por parte de las cuidadoras familiares, de las personas con enfermedad cardiovascular en la etapa final de la vida, así como de la patología misma. Además, se requiere un abordaje desde la multidimensionalidad humana para tomar decisiones acertadas y respetuosas culturalmente, con cuidados orientados al binomio (paciente-cuidador familiar).

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Guías de actuación clínica de la Sociedad Española de Cardiología en el infarto agudo de miocardio

Cited by 91 publications

References 152 publications

Hospital Resources and Myocardial Infarction Case Fatality. The IBERICA Study

Hospital Resources and Myocardial Infarction Case Fatality. The IBERICA Study

Incretin Therapy for Type 2 Diabetes in Spain: A Cost-Effectiveness Analysis of Liraglutide Versus Sitagliptin

Necesidad De Prácticas Cuidantes Culturalmente Congruentes: Personas Con Enfermedad Cardiovascular Al Final De La Vida

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