Resultados del primer registro chileno de angina inestable: características clínicas, perfil de riesgo y tratamiento / Results of the first Chilean registry of unstable angina: clinical features, risk profile and treatment

Background: From January 2000 to June 2002, the first Chilean registry of unstable angina was carried out, with the participation of 15 hospitals. Aim: To report the clinical and demographic features of 600 patients with unstable angina, their risk profile and prognosis. Material and methods: The inclusion criteria for this prospective registry were a history of recent onset of chest pain (<48 hours) or a change in the character of previous angina, associated to ischemic electrocardiographic changes and/or positive markers of myocardial damage. Results: Mean age of the patients was 65 years and 37 percent were women. Among coronary risk factors, 63 percent had hypertension, 27percent had diabetes, 52percent had dyslipidemia, 31percent smoked and 21percent had a family history of atherosclerosis. On admission 94percent of patients had chest pain, associated to ST segment depression in 44 percent, negative T waves in 28 percent and positive markers of myocardial damage in 30percent. Fifty seven percent received intravenous nitroglycerin, 47 percent received oral nitrates, 69 percent beta blockers and 15 percent, calcium antagonists. Antithrombotic therapy included aspirin in 96 percent, heparin in 74percent, ticlodipine or clopidogrel in 19 percent and IIb/IIIa inhibitors in 12percent. A coronary angiogram was performed in 52percent, angioplasty in 25percent and coronary bypass surgery in 13percent. Hospital mortality was 2.6percent. The incidence of new ischemic events was: myocardial infarction in 2.8percent recurrent ischemia in 9.5percent and refractory ischemia in 2percent. The incidence of adverse events increased according to a higher risk profile. Conclusions: The demographic and clinical features, treatment and mortality of these patients are similar to those reported in international registries, with a low mortality rate.

Seguimiento y sobrevida de pacientes con marcapasos reutilizados / Following and survival of patients with reutilized pacemakers

Revisamos los 265 implantes de marcapasos definitivos efectuados en Valdivia entre 1977 y 1988, con objeto de identificar la conducta adoptada en relación a la reutilización de éstos y caracterizar la población de pacientes que recibió dispositivos usados, estudiando su evolución y sobrevida, comparándola con la población de pacientes que recibió un marcapasos nuevo. Observamos que la reutilización de marcapasos inicialmente esporádica, se hizo luego una práctica más frecuente que en los últimos cinco años alcanzó a un 13 por ciento de los implantes y en el último año a un 25 por ciento de ellos (10 de 40). La edad promedio fue de 75 años para la población que recibió este tipo de dispositivos y de 69 años en el resto de los pacientes. Las curvas de sobrevida fueron similares para ambos grupos de pacientes en el período estudiado. No se observó complicaciones inflamatorias ni infecciosas en el grupo que recibió marcapasos usados