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| 24. |
- Swahn, Eva, et al.
(författare)
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Invasive Treatment of Non-ST-segment Elevation Acute Coronary Syndrome: Cardiac Catheterization/Revascularization for All? : [Tratamiento invasivo del síndrome coronario agudo sin elevación del segmento ST: ¿cateterismo cardiaco/ revascularización en todos los casos?]
- 2014
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Ingår i: Revista Española de Cardiología. - : Elsevier. - 0300-8932 .- 1579-2242 .- 1885-5857. ; 67:3, s. 218-221
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Tidskriftsartikel (refereegranskat)abstract
- Patients admitted to hospital with symptoms and signs of non-ST-segment elevation acute coronary syndromes have different risk profiles and are in need of an individualized approach that takes into consideration not only age and sex but also comorbidities such as diabetes, renal failure, hypertension, heart failure, peripheral artery disease, earlier revascularization, etc. According to evidence-based medicine and as documented in current guidelines, there is currently evidence for early catheterization and, if feasible, revascularization in high-risk patients, especially in men. Nevertheless, because of a lack of definitive evidence, there is uncertainty about treating women in the same way. Because women are usually older and have more comorbidities, they are frailer and revascularization should be indicated with greater caution. There is no evidence that catheterization as such is worse for women than for men; however, for both men and women with low risk, a less invasive approach, such as coronary computed tomography angiography, could be considered as a first diagnostic tool.
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| 27. |
- Tubaro, Marco, et al.
(författare)
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Pre-Hospital Treatment of STEMI Patients : A Scientific Statement of the Working Group Acute Cardiac Care of the European Society of Cardiology
- 2012
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Ingår i: Revista Española de Cardiología. - : Elsevier BV. - 0300-8932 .- 1579-2242. ; 65:1, s. 60-70
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Tidskriftsartikel (refereegranskat)abstract
- In ST-elevation myocardial infarction (STEMI) the pre-hospital phase is the most critical, as the administration of the most appropriate treatment in a timely manner is instrumental for mortality reduction. STEMI systems of care based on networks of medical institutions connected by an efficient emergency medical service are pivotal. The first steps are devoted to minimize the patient's delay in seeking care, rapidly dispatch a properly staffed and equipped ambulance to make the diagnosis on scene, deliver initial drug therapy and transport the patient to the most appropriate (not necessarily the closest) cardiac facility. Primary PCI is the treatment of choice, but thrombolysis followed by coronary angiography and possibly PCI is a valid alternative, according to patient's baseline risk, time from symptoms onset and primary PCI-related delay. Paramedics and nurses have an important role in pre-hospital STEMI care and their empowerment is essential to increase the eff ectiveness of the system. Strong cooperation between cardiologists and emergency medicine doctors is mandatory for optimal pre-hospital STEMI care. Scientific societies have an important role in guideline implementation as well as in developing quality indicators and performance measures; health care professionals must overcome existing barriers to optimal care together with political and administrative decision makers.
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| 28. |
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| 29. |
- Viadas, Raul, et al.
(författare)
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Association of physical activity with high-density lipoprotein functionality in a population-based cohort : the REGICOR study
- 2023
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Ingår i: Revista Española de Cardiología. - : Elsevier BV. - 0300-8932 .- 1579-2242. ; 76:2, s. 86-93
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Tidskriftsartikel (refereegranskat)abstract
- Introduction and objectives: To determine the dose-response association between current and past leisure-time physical activity (LTPA), total and at different intensities, and high-density lipoprotein (HDL) functionality parameters.Methods: Study participants (n = 642) were randomly drawn from a large population-based survey. Mean age of the participants was 63.2 years and 51.1% were women. The analysis included data from a baseline and a follow-up visit (median follow-up, 4 years). LTPA was assessed using validated questionnaires at both visits. Two main HDL functions were assessed: cholesterol efflux capacity and HDL antioxidant capacity, at the follow-up visit. Linear regression and linear additive models were used to assess the linear and nonlinear association between LTPA and HDL functionality.Results: Total LTPA at follow-up showed an inverse and linear relationship between 0 and 400 METs x min/d with HDL antioxidant capacity (regression coefficient [beta]:-0.022; 95%CI,-0.030,-0.013), with a plateau above this threshold. The results were similar for moderate (beta:-0.028; 95%CI,-0.049, -0.007) and vigorous (beta:-0.025; 95%CI,-0.043,-0.007), but not for light-intensity LTPA. LTPA at follow-up was not associated with cholesterol efflux capacity. Baseline LTPA was not associated with any of the HDL functionality parameters analyzed.Conclusions: Current moderate and vigorous LTPA showed a nonlinear association with higher HDL antioxidant capacity. Maximal benefit was observed with low-intermediate doses of total LTPA (up to 400 METs x min/d). Our results agree with current recommendations for moderate-vigorous LTPA practice and suggest an association between PA and HDL functionality in the general population.
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