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Economic burden of hypercholesterolemia in high risk of cardiovascular disease population in Mexico. 墨西哥心血管疾病高危人群高胆固醇血症的经济负担
IF 0.5 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2023-01-01 DOI: 10.24875/ACM.22000195
Ricardo Gasca-Pineda, Mariana Osorio-Hernández, Roopa Mehta, Jorge Escobedo-de-la-Peña, Carlos A Narváez-Oriani

Objective: To estimate the direct and indirect economic burden of hypercholesterolemia in patients with high risk of a cardiovascular event, specifically there were defined 5 groups of patients: 1) familial hypercholesterolemia; 2, 3 and 4) patients with hypercholesterolemia and background of diabetes, myocardial infarction or stroke; 5) diabetes, myocardial infarction and hypercholesterolemia (very high-risk patients) from the Mexican public healthcare institutions.

Methods: For the estimation of the direct costs the items included correspond to: outpatient care, pharmacological treatment, inpatient hospital care, and surgical procedures. For indirect economic burden, death certificates, before the end of the productive age due to hypercholesterolemia were calculated (premature mortality).

Results: The direct economic burden for the 5 groups of patients at risk is MXN $39,601,464,154 (USD $1,987,526,432), while the indirect economic burden amounts to MXN $121,646,689 (USD $6,105,229).

Conclusions: The economic impact of hypercholesterolemia in patients with high cardiovascular risk is $39,723,110,843 (equivalent to USD $1,993,631,661) and corresponds to the 0.16% of GDP.

目的:评估高胆固醇血症对心血管事件高危患者的直接和间接经济负担,具体分为5组患者:1)家族性高胆固醇血症;2、3和4)有糖尿病、心肌梗死或中风背景的高胆固醇血症患者;5)来自墨西哥公共医疗机构的糖尿病、心肌梗死和高胆固醇血症(高危患者)。方法:直接费用估算项目包括:门诊治疗、药物治疗、住院治疗和外科手术。对于间接经济负担,计算生产年龄结束前因高胆固醇血症导致的死亡证明(过早死亡)。结果:5组高危患者的直接经济负担为39,601,464,154美元(1,987,526,432美元),间接经济负担为121,646,689美元(6,105,229美元)。结论:高胆固醇血症对心血管高危患者的经济影响为39,723,110,843美元(相当于1,993,631,661美元),相当于GDP的0.16%。
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引用次数: 0
Damus-Kaye-Stansel surgery in a patient with tricuspid atresia, transposition of the great arteries, and type A aortic arch interruption. Damus-Kaye-Stansel手术治疗三尖瓣闭锁、大动脉转位和a型主动脉弓中断患者1例。
IF 0.5 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2023-01-01 DOI: 10.24875/ACM.22000054
Héctor M Jimenez-Vargas, Jorge L Cervantes-Salazar, Liliana López-Hernández, Leonardo Rivera-Rodríguez
*Correspondence: Leonardo Rivera-Rodríguez E-mail: rivleonard@gmail.com Available online: 26-07-2023 Arch Cardiol Mex (Eng). 2023;93(3):362-363 www.archivoscardiologia.com Date of reception: 10-02-2022 Date of acceptance: 16-09-2022 DOI: 10.24875/ACM.22000054 The tricuspid atresia is described as an absence of connection between the right atrium and right ventricle, it’s classified based on the relationship of the great vessels, the existence or absence of pulmonary stenosis, and the characteristics of the ventricular septal defect1. The association with interrupted aortic arch type A is rare. The actual treatment for these patients is palliative, specifically in those with D-transposition of the great vessels and left obstructive outflow tract, the Damus–Kaye–Stansel procedure (DKS) associated
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引用次数: 0
Acute myocarditis after administration of COVID-19 vaccine: comment. COVID-19疫苗接种后急性心肌炎:评论。
IF 0.5 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2023-01-01 DOI: 10.24875/ACM.23000079
Amnuay Kleebayoon, Viroj Wiwanitkit
We would like to share ideas on the publication “Acute myocarditis after administration of BNT162b2 vaccine against COVID-191”. Cueva-Recalde et al. present the case of a 28-year-old male patient with no prior medical history who has been experiencing chest pain for the past 3 days1. The patient was hospitalized but remained asymptomatic and did not require treatment1. Cueva-Recalde et al. stated that, while rare, physicians should be aware of this adverse event of COVID-19 vaccination, while bearing in mind its unquestionably positive benefit-risk profile1. We both agree that protecting the COVID-19 is essential and that more study is required to address the major clinical problem. The development of clinical diseases and immunization may be causally related. It might occasionally be difficult to identify the specific path-immunopharmacological link due to ignorance. If a clinical condition is thought to be related to the COVID-19 immunization, there are a few important factors that need to be taken into account. There is a chance of comorbidity. For instance, a concurrent dengue infection and vaccination could result in a clinical illness that was misdiagnosed2. Comorbidity is a likely ailment that might be misdiagnosed as a negative vaccination reaction. It may be difficult to understand how therapy methods are impacted by chronic medical conditions. It could be difficult to understand how persistent medical issues affect therapeutic strategies. The COVID-19, which is currently unidentified, must also be considered3. It is conceivable that a previous COVID-19 pandemic had an impact on the vaccine’s efficiency and results. Infection with COVID-19 may also have an impact on clinical outcomes. It is often challenging to completely rule out the effects of earlier asymptomatic illnesses without the required laboratory investigations. An important auxiliary factor is genetics4. The immune system’s response to certain genetic components may affect how it handles negative vaccine side effects. Understanding how the underlying genetic component impacts the clinical scenario regarding vaccine success would be very beneficial. This problem needs to be resolved if more research is to be done. Summative large-scale data may help researchers better comprehend the COVID19 vaccine’s effects.
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引用次数: 0
Anomaly of the origin of the coronary arteries, can it lead to cardiogenic shock? 冠状动脉起源异常,会导致心源性休克吗?
IF 0.5 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2023-01-01 DOI: 10.24875/ACM.22000189
José E Duarte-Arguello, Mario R García-Arias, José A Alvarado-Alvarado
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引用次数: 0
Analysis of medium-term adherence after the implementation of a cardiac rehabilitation program. 心脏康复计划实施后中期依从性分析。
IF 0.5 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2023-01-01 DOI: 10.24875/ACM.21000156
Alejandra Ruiz-Aranjuelo, Maruan C Chabbar-Boudet, Elena P Gambó-Ruberte, Carmen Albarrán-Martín, Carmen Untoria-Agustín, Fernando Garza-Benito

Objectives: Cardiac Rehabilitation Programs (CRP) are an excellent tool to achieve adherence to therapeutic. The aim of our study was analyzing at the medium-term adherence, as well as identifying low adherence predictors to pharmacological therapeutic compliance and changes in lifestyle.

Methods: Retrospective study of 100 patients referred to a CRP in 2018 after presenting ACS. At the one-year review adherence to diet, physical exercise, and smoking cessation were analyzed. Optimal adherence was considered if all three items were met. Compliance with taking medication was also studied using the Morisky-Green test. Finally, low adherence predictors were analyzed by lineal/logistic regression analysis.

Results: 98% of the patients presented acceptable adherence to the Mediterranean diet, 83% good adherence to physical exercise, and 79% of the smokers achieved the cessation of smoking. Regarding drug adherence, 97% of the patients complied correctly. 68% of the patients achieved good overall adherence. Eastern European nationality, sedentary lifestyle, and home-based CRP were predictors of low adherence. The youngest patients and the "blue collar" occupation showed a tendency to poor adherence, although not significantly.

Conclusions: In our environment there is good medium-term adherence to lifestyle changes and pharmacological compliance in patients who complete CRP after ACS. Eastern European nationality, sedentary lifestyle, and home-based programs were associated with poor adherence.

目的:心脏康复计划(CRP)是实现治疗依从性的极好工具。本研究的目的是分析中期依从性,以及确定药物治疗依从性和生活方式改变的低依从性预测因子。方法:回顾性研究2018年出现ACS后转介CRP的100例患者。在一年的回顾中,对饮食、体育锻炼和戒烟的依从性进行了分析。如果三个项目都满足,则认为最佳依从性。服药依从性也通过Morisky-Green试验进行了研究。最后,对低依从性的预测因子进行线性/逻辑回归分析。结果:98%的患者表现出可接受的地中海饮食依从性,83%的患者表现出良好的体育锻炼依从性,79%的吸烟者成功戒烟。在药物依从性方面,97%的患者正确依从。68%的患者获得了良好的总体依从性。东欧国籍、久坐不动的生活方式和基于家庭的CRP是低依从性的预测因子。最年轻的患者和“蓝领”职业表现出较差的依从性,尽管不明显。结论:在我们的环境中,ACS后完成CRP治疗的患者在生活方式改变和药物依从性方面有良好的中期依从性。东欧国籍、久坐不动的生活方式和以家庭为基础的项目与较差的依从性有关。
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引用次数: 0
Malignant coronary vasospasm refractory to nitrates: Using clevidipine as an emergent coronary vasodilator. 恶性冠状血管痉挛难治性硝酸盐:使用克利夫地平作为紧急冠状血管扩张剂。
IF 0.5 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2022-10-21 DOI: 10.24875/ACM.21000251
Yván R Persia-Paulino, Javier Cuevas-Pérez, Rodrigo Fernández-Asensio, Alejandro Junco-Vicente, Lisardo Iglesias-Fraile, Ana Ayesta
Coronary artery vasospasm is a cause of chest pain described more than 50 years ago by Prinzmetal et al., named as variant angina1. Now, it is commonly known as Prinzmetal angina or vasospastic angina (VA). Patients with VA have episodes of oppressive chest pain, characterized by diurnal variation and not with exercise (even at rest), that have good response to short acting oral nitrates and oral calcium channel blockers (CCB)1. Some patients with VA develop malignant ventricular arrythmias during ischemic episodes that lead to sudden death2. Although VA usually has a good response to oral nitrates and oral CCB, treatment of patients that cannot tolerate oral drugs (on the acute phase of sudden death, hemodynamically unstable or patients on mechanical ventilation) options are very reduced. In this case report, we present a patient with an outpatient aborted sudden death due to VA with frequent episodes of coronary arteries vasospasms with malignant ventricular arrythmias refractory to intravenous nitrates that responded to clevidipine, an intravenous CCB. A 65-years-old male patient was brought to the emergency room due to out-of-hospital cardiac arrest. Past medical history of hypertriglyceridemia and was an active smoker. Chronic medication included atorvastatin 20 mg once daily (OD) and acetylsalicylic acid 100 mg (OD). The patient suffered cardiac arrest while traveling on public bus and basic life support maneuvers were started until medical assistance arrived. The automated external defibrillator showed a ventricular fibrillation (VF) and after 2 shocks of 200 Joules (J) and 15 min of cardiopulmonary resuscitation maneuvers the patient recovered pulse. The 12-lead electrocardiogram (ECG) showed sinus tachycardia without signs of myocardial ischemia. The patient was transferred to the hospital with mechanical ventilation support. Once on the emergency room, the patient was hemodynamically stable without vasoactive drugs. No remarkable findings on physical examination. The ECG showed a sinus tachycardia without alterations suggestive of myocardial ischemia (Fig. 1A). An emergency echocardiogram was performed and normal size non-hypertrophic left ventricle with mild global hypokinesia (no regional alterations in contraction suggestive of coronary artery disease) was found. Anyways, hemodynamics laboratory was contacted for an urgent coronarography to exclude myocardial ischemia as the cause of VF.
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引用次数: 0
[Determinantes del puntaje PHQ 9 para síntomas depresivos mayores en trabajadores de la salud durante la pandemia de COVID-19 mediante técnicas de machine learning]. [利用机器学习技术确定 COVID-19 大流行期间医护人员主要抑郁症状的 PHQ 9 分值]。
IF 0.5 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2022-10-13 DOI: 10.24875/ACM.22000101
Battioni Luciano, Cristhian E Scatularo, Sebastián Bellia, Adrián Lescano, Stella M Pereiro, Julio Giorgini
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引用次数: 0
Should a recent SARS-CoV-2 infection be considered a risk or prognostic factor for ST-segment elevation myocardial infarction? 近期感染 SARS-CoV-2 是否应被视为 ST 段抬高型心肌梗死的风险或预后因素?
IF 0.5 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2022-09-08 DOI: 10.24875/ACM.22000153
Kietseé A Díaz-Domínguez, Andrés Cruz-Melendez, Luis M Amezcua-Castillo, Jazmin A Guerra-López, Claudia Tavera-Alonso, Héctor González-Pacheco, Luis M Amezcua-Guerra

Objective: The aim of the study was to assess whether a recent SARS-CoV-2 infection could by itself be a risk or prognostic factor for ST-segment elevation myocardial infarction (STEMI).

Method: An observational study in unvaccinated patients with STEMI confirmed by cardiac catheterization was conducted. A recent or concurrent SARS-CoV-2 infection was identified by the presence of serum IgG against the nucleocapsid protein, or a positive polymerase chain reaction test on nasopharyngeal swabs. Baseline cardiovascular risk factors, clinical STEMI severity, main catheterization findings, and occurrence of major adverse cardiovascular events (MACE) during hospitalization were compared between study subgroups.

Results: Of a total of 89 patients recruited, 14 (16%) had a recent SARS-CoV-2 infection. Patients with STEMI and recent SARS-CoV-2 infection had a markedly lower frequency of high blood pressure (20% versus 55%; P = 0.03) as well as a tendency to have fewer comorbidities. Regarding the clinical presentation, there were no differences in the severity of the STEMI. Furthermore, the main findings during cardiac catheterization including the atherosclerotic burden and the number of vessels affected, as well as the occurrence of MACE during follow-up, were not significantly different between the groups.

Conclusions: A recent SARS-CoV-2 infection appears to facilitate the triggering of STEMI, as these patients have fewer traditional cardiovascular risk factors than their uninfected counterparts. However, this does not seem to affect the clinical presentation or the in-hospital course of STEMI patients.

研究目的该研究旨在评估近期感染 SARS-CoV-2 是否会成为 ST 段抬高型心肌梗死(STEMI)的风险或预后因素:方法:对经心导管检查确诊为 STEMI 的未接种疫苗的患者进行观察研究。通过血清中出现针对核壳蛋白的 IgG 或鼻咽拭子聚合酶链反应检测呈阳性,确定患者近期或同时感染了 SARS-CoV-2。比较了各研究亚组的基线心血管危险因素、临床 STEMI 严重程度、主要导管检查结果以及住院期间主要不良心血管事件(MACE)的发生情况:在招募的 89 名患者中,有 14 人(16%)近期感染过 SARS-CoV-2。STEMI 和近期感染 SARS-CoV-2 的患者患高血压的比例明显较低(20% 对 55%;P = 0.03),合并症也较少。在临床表现方面,STEMI 的严重程度没有差异。此外,心导管检查的主要结果,包括动脉粥样硬化负荷和受影响血管的数量,以及随访期间MACE的发生率,在各组之间没有显著差异:结论:近期感染过 SARS-CoV-2 的患者似乎更容易诱发 STEMI,因为与未感染的患者相比,这些患者的传统心血管风险因素更少。然而,这似乎并不影响 STEMI 患者的临床表现或住院过程。
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引用次数: 0
Clinical impact of the infrapatellar location in symptomatic peripheral arterial disease patients. 髌下位置对症状性外周动脉疾病患者的临床影响。
IF 0.5 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2022-07-27 DOI: 10.24875/ACM.22000161
Juan G Chiabrando, Fernando D Garagoli, Maria M Abraham Foscolo, Giuliana Corna, Maria de Los Milagros Fleitas, Juan Valle-Raleigh, Horacio A Medina de Chazal, Daniel H Berrocal, Jose M Rabellino, Ignacio M Bluro

Background: Peripheral artery disease (PAD) frequently affects multiple segments of the limbs. Contradictory data have reported worse prognosis in aortoiliac lesions, nevertheless, diabetes and chronic limb ischemia frequently affects the infrapatellar territory. Our aim was to assess the impact of infrapatellar disease in cardiovascular outcomes.

Methods: We performed a retrospective, observational cohort study at a university hospital in Argentina. Electronic health records were retrospectively reviewed including symptomatic PAD patients requiring revascularization. A multivariable regression model was performed to account for confounders. The primary endpoint was a composite of hospitalizations due to chronic limb threatening ischemia (CLTI) and major amputation events between infrapatellar and suprapatellar patients. Minor amputation events, all-cause death, myocardial infarction (MI), stroke, and major cardiovascular events (MACE) were secondary endpoints.

Results: From January 2014 through July 2020, a total of 309 patients were included in the analysis. 151 patients had suprapatellar disease, and 158 had infrapatellar disease. The primary composite endpoint occurred in 35 patients (22.2%) in the infrapatellar patients and 18 patients (11.9%) in the suprapatellar patients (HR = 2.16; 95% confidence interval [CI]= [1.22-3.82]; p = 0.008). Both components of the primary outcomes occurred more frequently in infrapatellar patients.Minor amputation events were more prevalent in infrapatellar patients (HR = 5.09; 95% CI = [1.47-17.6]; p = 0.010). Death,MI, stroke, and MACE events were not different among groups (all p > 0.05).

Conclusion: Infrapatellar disease was anindependent factor for increased hospitalization of CLTI, major and minor amputations events, compared to suprapatellardisease in symptomatic revascularized PAD patients.

背景:外周动脉疾病(PAD)经常影响肢体的多个节段。矛盾的数据报道主动脉髂病变预后较差,然而,糖尿病和慢性肢体缺血经常影响髌下区域。我们的目的是评估髌下疾病对心血管预后的影响。方法:我们在阿根廷的一所大学医院进行了一项回顾性、观察性队列研究。回顾性回顾电子健康记录,包括需要血运重建术的有症状的PAD患者。采用多变量回归模型来考虑混杂因素。主要终点是由于慢性肢体威胁缺血(CLTI)和髌下和髌上患者之间的重大截肢事件而住院的综合。次要终点为轻微截肢事件、全因死亡、心肌梗死(MI)、中风和主要心血管事件(MACE)。结果:2014年1月至2020年7月,共纳入309例患者。髌骨上病变151例,髌骨下病变158例。主要复合终点出现在35例(22.2%)髌下患者和18例(11.9%)髌上患者(HR = 2.16;95%置信区间[CI]= [1.22-3.82];P = 0.008)。这两种主要结果在髌下患者中更常见。轻微截肢事件在髌下患者中更为普遍(HR = 5.09;95% ci = [1.47-17.6];P = 0.010)。死亡、心肌梗死、卒中和MACE事件组间无差异(均p > 0.05)。结论:与有症状的PAD患者的髌上疾病相比,髌下疾病是导致CLTI住院率和大小截肢事件增加的独立因素。
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引用次数: 0
Cardiogenic shock as the initial manifestation of takotsubo syndrome. 心源性休克为takotsubo综合征的首发表现。
IF 0.5 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2022-07-01 DOI: 10.24875/ACM.20000464
Mario R García-Arias, Jorge E -Tovilla, Jorge I García-Espinoza, Uriel Encarnación-Martínez, Rodrigo Gopar-Nieto, José L Briseño-De la Cruz
Mario R. García-Arias1,2*, Jorge E. Reyes-Tovilla1,2, Jorge I. García-Espinoza1,2, Uriel Encarnación-Martínez1,2, Rodrigo Gopar-Nieto3, and José L. Briseño-De la Cruz3 1Department of Cardiology, Instituto Nacional de Cardiología “Ignacio Chávez”; 2School of Medicine, Universidad Nacional Autónoma de México; 3Coronary Care Unit, Instituto Nacional de Cardiología “Ignacio Chávez”. Mexico City, Mexico SCIENTIFIC LETTER
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引用次数: 0
期刊
Archivos de cardiologia de Mexico
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