Archivos de cardiologia de Mexico最新文献

Objective: Describe the methodological aspects, sociodemographic, and clinical characteristics of patients hospitalized with acute decompensated heart failure (ADHF) and their short-term outcomes.

Methods: Prospective cohort of patients with ADHF from the emergency service of the cardiovascular center. Descriptive statistics were used to synthesize sociodemographic characteristics, clinical characteristics during hospitalization, and outcomes.

Results: 1595 patients with ADHF. The median age was 68 years (Q1 = 58; Q3 = 76), and 69.28% were men. The median hospital stay was 6 days (Q1 = 4; Q3 = 11), with an cumulative incidence for re-hospitalization at 30 days of 8.70% (95% CI 7.18-10.40%), in-hospital mortality cumulative incidence of 4.33% (95% CI 3.38-5.44%), and a median change in the quality-of-life score Minnesota Living with Heart Failure at 30 days of -20 points (Q1 = -37; Q3 = -5). At discharge, all patients had a percentage > 70% of the use of quadruple neurohormonal blockade therapy.

Conclusion: Institutional aCute decompensAted HeaRt FailUre RegiStry (ICARUS) is one of the first studies in Latin America to demonstrate the importance of characterizing the population with ADHF and the adherence to heart failure guidelines may have influenced the favorable clinical outcomes.

The formation of atherosclerotic plaque results from the complex interaction between modifiable and non-modifiable risk factors, through immune mechanisms that orchestrate both inflammatory and anti-inflammatory processes. Atherosclerosis often culminates in ischemic heart disease or cerebrovascular events, which are the leading causes of mortality worldwide. Currently, primary prevention focuses on controlling modifiable risk factors. Therefore, understanding the molecular mechanisms underlying the damage induced by these risk factors is essential to develop more effective treatments. This article provides a detailed review of the immunological processes underlying the initiation and progression of atheroma plaque, exploring their relationship with traditional risk factor such as smoking, diabetes mellitus, dyslipidemia, and hypertension, as well as a new potential risk factor: microbiota dysbiosis. Furthermore, the attributable risk of each factor is independently assessed, and the effectiveness of risk factor control measures is demonstrated as the best strategy to date for the regression of atherosclerosis and the prevention of its complications.

Platypnea-orthodeoxia syndrome (POS) is a rare clinical entity characterized by the onset of dyspnea and hypoxemia that normally manifests in the upright position, improving with recumbency. POS is generally caused by both anatomical and functional defects that lead to a right-to-left shunt. Herein, we present an illustrative case of POS in an elderly patient admitted for severe hypoxemia, in which a massive right-to-left shunt through a patent foramen ovale facilitated by an anatomic disturbance was found. Percutaneous closure of the defect was performed, thus correcting the POS.

Obesity is a significant risk factor for the development of cardiovascular diseases. This review addresses the complex interaction between obesity and cardiovascular risk, highlighting dysfunctional adiposity as a crucial precursor in the metabolic renal cardiovascular continuum. The underlying pathophysiological mechanisms are reviewed, emphasizing the importance of risk identification and proper stratification, as well as the various available treatment strategies, including pharmacological and non-pharmacological interventions that have proven to reduce cardiovascular risk. Practical tools and evidence-based strategies are provided to enhance clinical management and cardiovascular health outcomes in this particularly vulnerable patient population.

Objective: We evaluated whether five (rs12617336, rs12617656, rs1558957, rs3788979, and rs17574) single nucleotide polymorphisms located in the DPP4 gene that have not been sufficiently explored, are candidates to be risk markers of in-stent restenosis.

Methods: The genotypes were determined in 190 patients (60 patients with restenosis and 130 without restenosis) using 5'exonuclease TaqMan assays in accordance with the manufacturer's instructions (Applied Biosystems, Foster City, USA).

Results: The results showed that the CC genotype of the rs12617656 C/T SNP was associated with the risk of development restenosis after coronary stent under the co-dominant, and recessive models (odds ratios [OR] = 3.32, p = 0.0009, and OR = 4.96, p = 0.0008, respectively). In addition, our data showed that the genetic distribution of the rs12617336, rs1558957, rs3788979, and rs17574 SNPs were similar between patients with and without restenosis after coronary stenting. On the other hand, the haplotype analysis showed one haplotype (CTC) associated with restenosis susceptibility (p = 0.006).

Conclusion: Our study demonstrates that the rs12617656 genetic variant of the DPP4 gene is associated with the risk of developing in-stent restenosis in our population.

Cutaneous adverse drug reactions, or pharmacodermias, are the most common form of adverse drug reactions (ADR). It was our interest to know their epidemiological behavior in a tertiary hospital level in Mexico. We stablished the frequency of ADR in 61 infants and adults hospitalized patients and those seen in the outpatient Dermatology Clinic at the National Institute of Cardiology Ignacio Chávez in Mexico City (INCICh) over a period of 10 years. The most frequently diagnosed pharmacodermias were acneiform dermatitis, cutaneous hyperpigmentation and maculopapular exanthema mainly associated to prednisone, hydroxychloroquine, cephalothin, amiodarone and vitamin B-complex, although we registered less frequently more severe and hazardous reactions. These results were consistent with other reports in our country. Multiple drugs administered at a time was an important causative factor for the ADR. It is necessary for every practitioner to develop skills that permit the identification of these dermatoses in order to correctly manage each case and diminish the morbimortality associated.

Objective: This article aims to assess the adherence level to second-line therapy for cardiovascular prevention in a tertiary hospital in Mexico City and identify key barriers to adequate pharmacological adherence.

Methods: A single-center prospective cross-sectional study was conducted between August 2018 and February 2020. Sociodemographic data were collected, and the Morisky medication adherence scale was performed. Directed interviews during medical consultations were also conducted to determine reasons for non-adherence.

Results: Showed that out of 991 patients included with a median age of 65 (58.72) years, 70.3% exhibited inadequate adherence, with forgetfulness being the most common reason (55.4%). Patients receiving combined therapy with coronary revascularization showed higher adherence compared to those on optimal medical therapy alone. Low educational level (OR 1.68, IC 95% 1.23-2.23, p = 0.0001) and the use of optimal medical therapy alone (OR 1.2, I 95% 1.11-2.007 p = 0.007) were identified as predictors of poor adherence.

Conclusion: Among patients with ischemic heart disease and pharmacological therapy for secondary prevention, inadequate adherence is observed in 70% of cases. Factors associated with poor pharmacological adherence were low educational level and prescription of medical therapy without revascularization.