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1.
Rev. Pesqui. (Univ. Fed. Estado Rio J., Online) ; 12: 586-592, jan.-dez. 2020. tab
Article in English, Portuguese | LILACS (Americas), BDENF | ID: biblio-1096991

ABSTRACT

Objetivo: verificar quais os desfechos clínicos dos usuários internados em uma Unidade de Terapia Intensiva Coronariana de um hospital no sul de Mato Grosso. Método: estudo do tipo coorte retrospectivo, documental, com abordagem quantitativa, com 593 usuários durante o ano de 2017. Resultados: verificou-se significância em relação ao desfecho clínico óbito no bloco de distúrbios mecânicos, em relação ao número menor de admissões e proporcionalmente um aumento do desfecho óbito com 36,3% o que reflete a associação estatística entre as variáveis (p-valor=0,0184); Também é imperativo destacar a relação entre o número de altas e de óbitos a partir do décimo sexto dia de internação, ocorrendo associação entre as varáveis (p-valor= 0,00001). Conclusão: espera-se que a partir dos dados sociodemográficos e clínicos dos usuários atendidos, a instituição consiga implementar da assistência ofertada, com foco no atendimento especializado, de modo a repercutir na redução do desfecho óbito na Unidade Coronariana


Objective: to verify the clinical outcomes of patients hospitalized in a Coronary Intensive Care Unit of a hospital in the south of Mato Grosso. Method: a retrospective, documental cohort study with a quantitative approach, with a sample of 593 users during the year 2017. Results: significance was verified regarding the clinical outcome of death in the block of mechanical disorders, in relation to the lower number of admissions and proportionately an increase in the death outcome with 36.3%, which reflects the statistical association between the variables (p-value = 0.0184); It is also imperative to highlight the relationship between the number of discharges and deaths from the sixteenth day of hospitalization, with an association between the variables (p-value = 0.00001). Conclusion: based on the socio-demographic and clinical data of the patients served, the institution is able to implement the offered assistance, focusing on the specialized care, so as to pass on the reduction of the death outcome in the Coronary Unit


Objetivo: verificar los resultados clínicos de los usuarios internados en una Unidad de Terapia Intensiva Coronaria de un hospital en el sur de Mato Grosso. Método: estudio del tipo cohorte retrospectivo, documental, con abordaje cuantitativo, con muestra de 593 usuarios durante el año 2017. Resultados: se verificó significancia en relación al desenlace clínico óbito en el bloque de disturbios mecánicos, en relación al número menor de admisiones y proporcionalmente un aumento del desencadenamiento óbito con 36,3% lo que refleja la asociación estadística entre las variables (p-valor = 0,0184); También es imperativo destacar la relación entre el número de altas y de muertes a partir del décimo sexto día de internación, ocurriendo asociación entre las variables (p-valor = 0,00001). Conclusión: se espera que a partir de los datos sociodemográficos y clínicos de los usuarios atendidos, la institución consiga implementar la asistencia ofrecida, con foco en la atención especializada, para repercutir en la reducción del desenlace muerto en la Unidad Coronaria


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Cardiovascular Diseases/mortality , Coronary Care Units/statistics & numerical data , Intensive Care Units/statistics & numerical data , Aging , Retrospective Studies , Outcome Assessment, Health Care
4.
Rev. cuba. salud pública ; 45(4)oct.-dic. 2019. tab, graf
Article in Spanish | LILACS (Americas), CUMED | ID: biblio-1093851

ABSTRACT

Introducción: Las enfermedades cardiovasculares son el principal grupo de causas de muerte en México. Objetivo: Analizar la tendencia de las enfermedades cardiovasculares en México por sexo, edad, causa de muerte; y su impacto en la esperanza de vida entre 1990-2015. Métodos: Estudio descriptivo con información de estadísticas vitales de mortalidad en México. Se calcularon tasas estandarizadas de mortalidad por enfermedades isquémicas, enfermedades hipertensivas, enfermedades cerebrovasculares, otras enfermedades del corazón y otras enfermedades cardiovasculares. Se analizó la tendencia de las tasas mediante una regresión de modelos segmentados; se calcularon las contribuciones al cambio en esperanza de vida por causa y por edad. Resultados: La tendencia de la mortalidad por enfermedades cardiovasculares presentó tres periodos: entre 1990-1997 se produjo un incremento en ambos sexos; en 1997-2000 una tendencia decreciente y entre 2000-2015 una tendencia estacionaria en mujeres y creciente en hombres. La mortalidad por enfermedades isquémicas del corazón y enfermedades hipertensivas se incrementaron en hombres y mujeres con el consecuente aporte negativo a la esperanza de vida. Por el contrario, las enfermedades cerebrovasculares disminuyeron con ganancias a la esperanza de vida. Las otras enfermedades del corazón tendieron a disminuir aumentando la esperanza de vida en los dos sexos. Conclusiones: En México existe una diminución de la mortalidad por algunas enfermedades cardiovasculares específicas con un aporte positivo a la esperanza de vida en los adultos mayores. Sin embargo, existen otras que inciden en un incremento en la mortalidad, lo que disminuye la esperanza de vida de la población, principalmente la de los adultos mayores(AU)


Introduction: Cardiovascular diseases are the main causes of death´s group in Mexico. Objective: To analyze trends of cardiovascular diseases in Mexico by sex, age, cause of death; and their impact in life expectancy from 1990 to 2015. Methods: To analyze trends of cardiovascular diseases in Mexico by sex, age, cause of death; and their impact in life expectancy from 1990 to 2015. Results: The trend of mortality by cardiovascular diseases presented three periods: between 1990 and 1997 there was an increase in both sexes; in 1997-2000 a decreasing trend; and between 2000-2015 a stationary trend in women and growing in men. The mortality due to ischemic heart disease and hypertensive diseases increased in men and women with consequent negative contribution to the life expectancy. On the contrary, cerebrovascular diseases decreased with gains in life expectancy. The other heart diseases tended to decrease by increasing life expectancy in both sexes. Conclusions: In Mexico there is a decrease in mortality due to specific cardiovascular diseases with a positive contribution to the life expectancy in older adults; however, there are others that have a bearing in an increase in mortality, which decreases the life expectancy of the population, mainly for older adults(AU)


Subject(s)
Humans , Male , Female , Aged , Aged, 80 and over , Cardiovascular Diseases/mortality , Life Expectancy/trends , Epidemiology, Descriptive , Mexico
6.
Int. j. cardiovasc. sci. (Impr.) ; 32(4): 391-395, July-Aug. 2019. graf
Article in English | LILACS (Americas) | ID: biblio-1012351

ABSTRACT

Prior statements have recommended restriction from competitive sports participation for all athletes with ICDs. Recent data, however, suggests that many athletes can participate in sports without adverse events. In the ICD Sports Registry, 440 athletes, aged 8-60 years, 77 of which were high-level interscholastic athletes, who had continued to practice sports, were prospectively followed for 4 years, with no deaths or failures to defibrillate during practice, and no injuries related to arrhythmia or shock during sports. Shocks did occur, for ventricular and supraventricular arrhythmias. While more athletes received shocks during physical activity than at rest, there were no differences between competition or practice, versus other physical activity. Programming with higher rate cut-offs and longer durations was associated with fewer inappropriate shocks, with no increase in syncope. Based on this study, current recommendations now state that returning to competition may be considered for an athlete with an ICD. In considering this decision, the underlying disease and type of sport should be discussed, and shared decision-making between doctor, patient, and often family, is critical


Subject(s)
Humans , Male , Female , Child , Adolescent , Adult , Middle Aged , Sports , Defibrillators, Implantable , Athletes , Quality of Life , Sports , Syncope , Cardiovascular Diseases/mortality , Exercise , Death, Sudden, Cardiac/prevention & control , Electrocardiography/methods
7.
Int. j. cardiovasc. sci. (Impr.) ; 32(4): 343-354, July-Aug. 2019. tab
Article in English | LILACS (Americas) | ID: biblio-1012341

ABSTRACT

Peak oxygen consumption (VO2peak) is an important prognostic marker and its classification helps the cardiologist in the therapeutic decision-making process. The most commonly used cardiorespiratory fitness (CRF) classification has not been validated for the Brazilian population. Objective: To elaborate a CRF classification using a Brazilian sample and to compare it with the American Heart Association (AHA), Cooper and UNIFESP classifications. Methods: A total of 6,568 healthy subjects were analyzed through cardiopulmonary exercise testing (CPET). They were distributed by sex and the following age groups (years): 7-12, 13-19, 20-79 (per decades) and > 80 years. After measurement of the VO2peak, participants were distributed into quintiles of CRF in very poor, poor, moderate, high and very high (AEMA Table). The CRF classifications by AEMA, AHA, Cooper, and UNIFESP were compared using the Wilcoxon, Kappa and concordance percentages. Results: VO2peak presented an inverse and moderate correlation with age considering both sexes (R = -0.488, p < 0.001). All paired comparisons between CRF classification systems showed differences (p < 0.001) and disagreement percentage - AEMA versus AHA (k = 0.291, 56.7%), AEMA versus Cooper (k = 0.220, 62.4%) and AEMA versus UNIFESP (k = 0.201, 63.9 %). Conclusion: The AEMA table showed important discrepancies in the classification of CRF when compared to other tables widely used in our setting. Because it was obtained from a large sample of the Brazilian population, the AEMA table should be preferred over other classification systems in our population


Subject(s)
Humans , Male , Female , Brazil , Sampling Studies , Cardiorespiratory Fitness , Oxygen Consumption , Echocardiography/methods , Cardiovascular Diseases/mortality , Exercise , Sex Factors , Statistical Analysis , Age Factors , Electrocardiography/methods , Exercise Test/methods , Population Health
8.
Rev. Soc. Cardiol. Estado de Säo Paulo ; 29(3 Supl): 291-296, jul.-set. 2019. tab, graf
Article in Portuguese | LILACS (Americas) | ID: biblio-1023081

ABSTRACT

Avaliar a eficácia diagnóstica da angiotomografia coronariana (AC) comparada com a cineangiocoronariografia (CAT). Material e Métodos: Foram avaliados retrospectivamente 146 pacientes submetidos a AC e CAT com angiografia coronariana quantitativa (ACQ), com intervalo médio de um mês entre os exames. O estudo foi realizado no Hospital Cardiológico Costantini. Foram avaliados os fatores de risco da amostra, a localização das lesões e o grau de severidade da obstrução coronariana nos grandes vasos (TCE, DA, CX e CD). Os resultados dos métodos diagnósticos foram comparados pelo coeficiente de correlação de Pearson. A partir dos achados positivos foi realizada a avaliação de correlação entre os métodos perante a severidade das lesões. Resultados: A amostra foi composta predominantemente por homens (73,97%), sendo a hipertensão arterial (HAS) (71,91%) o fator de risco mais frequente. A artéria mais acometida foi a DA. Quanto ao grau de severidade das lesões, os resultados foram os seguintes na comparação entre AC e CAT: lesões discretas com correlação r = 0,23; moderadas com r = 0,53 e severas com r = 0,70. Na comparação entre AC e ACQ: lesões discretas com correlação r = 0,45; moderadas com r = 0,70 e severas com r = 0,67. Conclusão: A AC apresentou moderada com ACQ e CAT em lesões moderadas e severas, e forte correlação na ausência de lesões quando comparada com ACQ


To evaluate the diagnostic efficacy of multislice CT coronary angiotomography compared with coronary cineangiography. Material and Methods: We retrospectively evaluated 146 patients submitted to MSCT and CA with quantitative coronary angiography (QCA), with a mean interval of one month between the exams. The study was carried out at the Costantini Cardiology Hospital. The risk factors for the sample, the location of the lesions and the degree of severity of the coronary obstruction in the large vessels (LCT, AD, CX and RC).The results of the diagnostic methods were compared using Pearson correlation coefficient. From the positive findings, a correlation evaluation was performed between the methods for the severity of the lesions. Results: The sample consisted predominantly of men (73.97%), and hypertension (SAH) (71.91%) was the most frequent risk factor. The most affected artery was AD. Regarding the degree of severity of the lesions, the results were as follows in the comparison between MSCT and CA: mild lesions with correlation r = 0.23, moderate with r = 0.53 and severe with r = 0.70. In the comparison between MSCT and QCA: mild lesions with correlation r = 0.45, moderate with r = 0.70 and severe with r = 0.67. Conclusion: MSCT showed moderate correlation with QCA and CA in moderate and severe lesions, and a strong correlation in the absence of lesions when compared with QCA


Subject(s)
Humans , Male , Female , Coronary Artery Disease/diagnostic imaging , Angiography/methods , Angiography, Digital Subtraction/methods , Coronary Angiography/methods , Diagnostic Imaging/methods , Cardiovascular Diseases/mortality , Retrospective Studies , Risk Factors , Magnetic Resonance Angiography/methods , Computed Tomography Angiography/methods , Hypertension
9.
Rev. Soc. Cardiol. Estado de Säo Paulo ; 29(3 Supl): 306-313, jul.-set. 2019. tab
Article in Portuguese | LILACS (Americas) | ID: biblio-1023176

ABSTRACT

A doença arterial coronariana (DAC) é umas das doenças cardiovasculares que mais mata no Brasil e no mundo. É uma doença multifatorial, associada a fatores de risco modificáveis. Além dos tratamentos convencionais, é recomendado que pacientes com DAC também incluam modificações no estilo de vida e programas de reabilitação cardiovascular com ênfase no exercício físico (RCEE) em seu tratamento. Sabidamente, o exercício físico regular somado às mudanças no estilo de vida contribui para a diminuição do avanço da doença aterosclerótica e da mortalidade dos pacientes com DAC. Além disso, o exercício físico tem impacto benéfico na capacidade funcional e qualidade de vida. Um programa de RCEE é uma estratégia eficaz, segura e com excelente razão de custo-benefício para o tratamento da DAC. Contudo, mesmo sendo uma terapia recomendada pelos principais órgãos de saúde, no Brasil as políticas públicas de saúde são extremamente escassas e a quantidade de centros especializados que oferecem a RCEE também é baixa. Problemas de adesão, participação e motivação são evidentes quando os programas são avaliados. Esta revisão mostra os principais estudos que, ao longo das últimas décadas, deram base para as recomendações da RCEE e faz uma análise crítica do cenário atual, deixando claro que novas estratégias de atuação e monitoramento devem ser exploradas e incentivadas para que os programas de RCEE sejam incluídos efetivamente no tratamento dos pacientes com DAC


Coronary artery disease (CAD) is one of the most lethal cardiovascular diseases both in Brazil and worldwide. It is a multifactorial disease associated with modifiable risk factors. In addition to conventional treatments, it is recommended that patients with CAD also include lifestyle changes and exercise-based cardiovascular rehabilitation (CR) programs in their treatment. It is well known that regular physical exercise combined with lifestyle changes contributes to a reduction in the progression of atherosclerosis and in mortality in patients with CAD. Moreover, physical exercise has a beneficial impact on functional capacity and quality of life. A CR program is an effective, safe strategy for the treatment of CAD with an excellent cost-benefit ratio. However, even though it is a therapy recommended by the main health agencies, public health policies in Brazil are extremely scarce and the number of specialized centers that offer CR is low. Problems of adherence, participation, and motivation are evident when these programs are evaluated. This review looks at the main studies that have been the basis for the recommendations of CR over last decades and critically analyzes the current scenario, making it clear that new strategies for action and monitoring should be explored and encouraged such that CR programs will be included effectively in the treatment of patients with CAD


Subject(s)
Humans , Male , Female , Middle Aged , Coronary Artery Disease , Exercise , Cardiac Rehabilitation/methods , Quality of Life , Cardiovascular Diseases/mortality , Cardiovascular Diseases/therapy , Chronic Disease/mortality , Risk Factors , Plaque, Atherosclerotic , Heart Rate
10.
Int. j. cardiovasc. sci. (Impr.) ; 32(3): 274-282, May-June 2019. tab, ilus
Article in English | LILACS (Americas) | ID: biblio-1002225

ABSTRACT

Cardiovascular diseases (CVD) are the main cause of death globally and most CVD can be prevented by addressing their risk factors, such as an unhealthy diet. Many authors have studied the benefits of nut consumption on CVD. Nuts contain high amounts of vegetable protein, unsaturated fatty acids, dietary fibers, vitamins, minerals and many other bioactive compounds, like phytosterols and phenolic compounds, which are able to reduce cholesterol levels and promote antioxidant and anti-inflammatory effects, thereby reducing cardiovascular risks. This review aims to describe studies involving the consumption of nuts, including Brazil nuts and CVD risk factors with positive results in the improvement of lipid profile, glucose metabolism, vascular function, and inflammatory and oxidative stress biomarkers


Subject(s)
Humans , Male , Female , Brazil , Cardiovascular Diseases/mortality , Nuts , Seeds , Biomarkers , Cholesterol , Risk Factors , Diet, High-Protein , Hypertension , Cholesterol, HDL/analysis , Cholesterol, LDL/analysis , Anti-Inflammatory Agents , Antioxidants
12.
Int. j. cardiovasc. sci. (Impr.) ; 32(3): 261-268, May-June 2019. tab
Article in English | LILACS (Americas) | ID: biblio-1002231

ABSTRACT

Smoking is the most important risk factor for coronary heart disease (CHD) and ischemic events; alcohol consumption, on the other hand, appears to have a protective role. Objective: Assess the association between smoking and alcohol consumption with the severity of coronary artery injuries in patients with acute myocardial infarction (AMI). Methods: Cross-sectional study, performed in Santa Catarina. Variables were evaluated using the Chi-squared T/Fisher's exact test, Kendall's correlation coefficient, Student's t test or Mann-Whitney U test. Values of p < 0.05 were considered significant. Results: Between August 2016 to June 2017, 226 patients were evaluated with first episode of AMI. There was a difference in sex distribution, showing that 59.7% of men and 85.4% of women were not alcoholic (p < 0.001). There was a higher prevalence of non-hypertensive patients who consumed alcohol than hypertensive ones (40.7% vs. 24.4% and p = 0.010) and patients without diabetes who had drinking habits than those diabetic (36.4% vs. 12.0% and p = 0.001). There was also a higher prevalence of non-diabetic patients who smoked than diabetic ones (38.1% vs. 22.0% and p = 0.035). A weak and negative correlation was found between the number of cigarettes per day and the pack-year with the TIMI frame count (r = -0.174 and p = 0.041 and r = -0.192 and p = 0.027, respectively). The other associations did not show statistical significance. Conclusion: The study showed that the number of cigarettes consumed per day and the pack-year is related to a smaller TIMI frame count, i.e., to a better coronary flow, which may be related to the Smoker's Paradox. There was no correlation between the beverage type and quantity with the SYNTAX score, Ejection fraction and TIMI frame count


Subject(s)
Humans , Male , Female , Tobacco Use Disorder/complications , Coronary Artery Disease/mortality , Alcohol Drinking/adverse effects , Myocardial Infarction , Stroke Volume , Cardiovascular Diseases/mortality , Sex Factors , Prevalence , Cross-Sectional Studies , Statistical Analysis , Risk Factors , Diabetes Mellitus , Hospitals, Public
14.
Int. j. cardiovasc. sci. (Impr.) ; 32(3): 261-268, may.-june. 2019. tab
Article in English | LILACS (Americas) | ID: biblio-1006090

ABSTRACT

Background: Smoking is the most important risk factor for coronary heart disease (CHD) and ischemic events; alcohol consumption, on the other hand, appears to have a protective role. Objective: Assess the association between smoking and alcohol consumption with the severity of coronary artery injuries in patients with acute myocardial infarction (AMI). Methods: Cross-sectional study, performed in Santa Catarina. Variables were evaluated using the Chi-squared T/Fisher's exact test, Kendall's correlation coefficient, Student's t test or Mann-Whitney U test. Values of p < 0.05 were considered significant. Results: Between August 2016 to June 2017, 226 patients were evaluated with first episode of AMI. There was a difference in sex distribution, showing that 59.7% of men and 85.4% of women were not alcoholic (p < 0.001). There was a higher prevalence of non-hypertensive patients who consumed alcohol than hypertensive ones (40.7% vs. 24.4% and p = 0.010) and patients without diabetes who had drinking habits than those diabetic (36.4% vs. 12.0% and p = 0.001). There was also a higher prevalence of non-diabetic patients who smoked than diabetic ones (38.1% vs. 22.0% and p = 0.035). A weak and negative correlation was found between the number of cigarettes per day and the pack-year with the TIMI frame count (r = -0.174 and p = 0.041 and r = -0.192 and - = 0.027, respectively). The other associations did not show statistical significance. Conclusion: The study showed that the number of cigarettes consumed per day and the pack-year is related to a smaller TIMI frame count, i.e., to a better coronary flow, which may be related to the Smoker's Paradox. There was no correlation between the beverage type and quantity with the SYNTAX score, Ejection fraction and TIMI frame count


Subject(s)
Humans , Male , Female , Tobacco Use Disorder/complications , Coronary Artery Disease/mortality , Alcohol Drinking/adverse effects , Myocardial Infarction , Stroke Volume , Cardiovascular Diseases/mortality , Sex Factors , Prevalence , Cross-Sectional Studies , Statistical Analysis , Risk Factors , Diabetes Mellitus , Hospitals, Public
15.
Int. j. cardiovasc. sci. (Impr.) ; 32(3): 274-282, may.-june. 2019. ilus, tab
Article in English | LILACS (Americas) | ID: biblio-1006132

ABSTRACT

Cardiovascular diseases (CVD) are the main cause of death globally and most CVD can be prevented by addressing their risk factors, such as an unhealthy diet. Many authors have studied the benefits of nut consumption on CVD. Nuts contain high amounts of vegetable protein, unsaturated fatty acids, dietary fibers, vitamins, minerals and many other bioactive compounds, like phytosterols and phenolic compounds, which are able to reduce cholesterol levels and promote antioxidant and anti-inflammatory effects, thereby reducing cardiovascular risks. This review aims to describe studies involving the consumption of nuts, including Brazil nuts and CVD risk factors with positive results in the improvement of lipid profile, glucose metabolism, vascular function, and inflammatory and oxidative stress biomarkers


Subject(s)
Humans , Male , Female , Brazil , Cardiovascular Diseases/mortality , Nuts , Seeds , Biomarkers , Cholesterol , Risk Factors , Diet, High-Protein , Hypertension , Cholesterol, HDL/analysis , Cholesterol, LDL/analysis , Anti-Inflammatory Agents , Antioxidants
16.
Rev. Soc. Cardiol. Estado de Säo Paulo ; 29(2): 133-136, abr.-jun. 2019.
Article in Portuguese | LILACS (Americas), SES-SP, SESSP-IDPCPROD, SES-SP | ID: biblio-1009419

ABSTRACT

As doenças cardiovasculares, principalmente as decorrentes de casos de acidente vascular cerebral e infarto agudo do miocárdio, têm importante impacto na mortalidade global e nas internações hospitalares em todo o mundo. A despeito do vasto conhecimento dos diversos fatores de risco implicados na gênese da doença cardiovascular, o número de eventos ainda se mantém elevado e a instituição de medidas de prevenção primária e secundária são essenciais e complementares. Nos últimos anos, importantes avanços no campo do tratamento farmacológico de aterosclerose e insuficiência cardíaca, predominantemente em decorrência de cardiopatia isquêmica, foram publicados e seus principais resultados são destacados no presente artigo


Cardiovascular diseases, particularly those arising from cases of stroke and acute myocardial infarction, have a significant impact on global mortality and hospital admissions around the world. Despite the vast knowledge of the various risk factors involved in the genesis of cardiovascular disease, the number of events remains high and institution of primary and secondary prevention measures is essential and complementary. In recent years, important advances in the field of pharmacological treatment of atherosclerosis and heart failure, particularly those arising from ischemic heart disease, have been published. The main results are highlighted in this article


Subject(s)
Humans , Male , Female , Cardiovascular Diseases/mortality , Cardiovascular Diseases/prevention & control , Secondary Prevention/methods , Therapeutics/methods , Risk Factors , Diabetes Mellitus , Atherosclerosis , Canagliflozin/therapeutic use , Rivaroxaban/therapeutic use , Valsartan/therapeutic use , Heart Failure , Anti-Inflammatory Agents/therapeutic use , Motor Activity
17.
Rev. Soc. Cardiol. Estado de Säo Paulo ; 29(2 (Supl)): 187-191, abr.-jun. 2019. tab, ilus
Article in Portuguese | LILACS (Americas) | ID: biblio-1009725

ABSTRACT

Times de Resposta Rápida (TRR) são equipes multidisciplinares treinadas para atender indivíduos com intercorrências agudas e graves, incluindo parada cardiorrespiratória (PCR) súbita, nas unidades de internação. O objetivo deste trabalho é discutir as particularidades do emprego de um TRR hospitalar no atendimento de PCRs extra-hospitalares, utilizando a experiência do time do Instituto Central do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (ICHC-FMUSP) para elucidação. Metodologia: Estudo retrospectivo, descritivo, utilizando o banco de dados do TRR do ICHC-FMUSP. Foram levantados todos os casos classificados como PCR súbita atendidos em ambiente extra-hospitalar, nos anos de 2014 a 2016. Dados globais de cinco pacientes que evoluíram com alta hospitalar e nível neurológico preservado foram descritos e analisados em detalhes. Resultados: Entre 11 atendimentos, oito tiveram retorno da circulação espontânea (RCE) na cena (72,2%) e três morreram no local. Dos oito pacientes admitidos com vida no Departamento de Emergência, cinco tiveram alta hospitalar após o evento (45,5%). A média de tempo de resposta foi 3 ± 1,2 minutos e o intervalo chamada-choque foi de 7,25 ± 3,2 minutos. Os ritmos de parada foram fibrilação ventricular (80%) e atividade elétrica sem pulso (20%). Dois pacientes foram diagnosticados com doença coronariana grave e quatro receberam um cardiodesfibrilador implantável (CDI) para profilaxia secundária de morte súbita. Um paciente, entre os cinco que tiveram alta, faleceu em outro serviço. Conclusão: Apesar de pouco usual, o emprego de um TRR hospitalar no atendimento de PCRs extra-hospitalares pode ser benéfico. Os desfechos favoráveis provavelmente decorreram do treinamento da equipe e da rapidez na realização do atendimento. A investigação cardiológica dos sobreviventes identificou pacientes com doenças graves, que, portanto, mais se beneficiariam da assistência de um time especializado


Introduction: Rapid Response Teams (RRT) are multidisciplinary groups trained to treat individuals with severe and acute events, including sudden cardiac arrest (CA), in in-patient units. The aim of this report is to discuss the singularities of deploying a hospital RRT for out-of-hospital CA assistance, using the experience of the team at the Instituto Central of Hospital das Clínicas of the University of São Paulo School of Medicine (ICHC-FMUSP) as illustration. Methodology: A retrospective, descriptive analysis was conducted, using the RRT database of the ICHC-FMUSP. All cases classified as sudden CA treated outside of the hospital between 2014 and 2016 were surveyed. Global data for five patients who progressed to discharge from hospital free of neuro - logical impairment were described and analyzed in detail. Results: Of the 11 cases, 8 had return of spontaneous circulation (ROSC) at the scene (72.2%), and 3 died on site. Of the 8 patients admitted to the Emergency Department, 5 were discharged from the hospital after the event (45.5%). The average response time was 3±1.2minutes, and the call-to-shock time interval was 7.25±3.2minutes. The cardiac arrest rhythms were ventricular fibrillation (80%) and pulseless electrical activity (20%). Two patients were diagnosed with severe coronary disease and four received an implantable cardioverter-defibrillator (ICD) for secondary prophylaxis of sudden death. One patient, of the 5 discharged, died in another unit. Conclusion: Although unusual, the use of a hospital RRT for out-of-hospital CA assistance can be beneficial. The favorable outcomes likely resulted from the team's training and the speed with which the treatment was given. Cardiovascular evaluation of the survivors identified patents with severe diseases, which would, therefore, most benefit from the care of a specialized team


Subject(s)
Humans , Male , Female , Aged , Hospital Rapid Response Team , Out-of-Hospital Cardiac Arrest/diagnosis , Heart Arrest , Ventricular Fibrillation/complications , Coronary Artery Disease/complications , Echocardiography/methods , Magnetic Resonance Spectroscopy/methods , Cardiovascular Diseases/mortality , Retrospective Studies , Death, Sudden, Cardiac , Defibrillators, Implantable , Electrocardiography/methods , Inpatient Care Units
18.
Rev. Soc. Cardiol. Estado de Säo Paulo ; 29(2 (Supl)): 197-200, abr.-jun. 2019. ilus, tab
Article in Portuguese | LILACS (Americas) | ID: biblio-1009734

ABSTRACT

A doença aterosclerótica crônica (DAC) é uma condição bastante prevalente em nosso meio e uma das principais doenças cardiovasculares ligadas ao envelhecimento. Dentre as opções terapêuticas adjuvantes, o Picnogenol ®, extrato da casca do Pinus pinaster, tem sido alvo de estudo em decorrência de função antioxidante, anti-inflamatória e antiplaquetária. Este artigo é uma revisão narrativa, cujo objetivo é avaliar o uso do Picnogenol® como opção terapêutica da DAC. Os estudos incluídos foram pesquisados nas bases de dados: PubMed, Scielo, The Cochrane Library, Scopus e LILACS, sendo excluídos, considerando suas restrições para avaliação terapêutica, os relatos de caso e séries de caso com n ≤ 5. Como resultado, os estudos têm apontado vantagens do uso Picnogenol® no tratamento da DAC, assim como de outras doenças cardiovasculares, porém, o número de pesquisas ainda é pequeno (principalmente ensaios clínicos) e há importantes limitações de tamanho amostral, o que dificulta sua atual recomendação na prática clínica


Chronic atherosclerosis is a highly prevalent condition and one of the main cardiovascular diseases linked to the aging process. Among the adjuvant therapeutic options, Pycnogenol® (Pinus pinaster bark extract) has been studied because of its antioxidant, anti-inflammatory and antiplatelet functions. This article is a narrative review aimed at evaluating the use of Pycnogenol® as a therapeutic option in the treatment of chronic atherosclerosis. The studies included were obtained from the following databases: PubMed, Scielo, The Cochrane Library, Scopus and LILACS. Case reports and case series with n≤5 were excluded due to their restrictions for therapeutic evaluation. As a result, the studies have indicated advantages in the use of Pycnogenol® in the treatment of chronic atherosclerosis as well as other cardiovascular diseases. However, the number of studies is still small (particularly clinical trials), and there are important sample size limitations, which restricts its current recommendation in clinical practice


Subject(s)
Humans , Male , Female , Pinus , Atherosclerosis/physiopathology , Aging , Cardiovascular Diseases/mortality , Chronic Disease , Risk Factors , Diabetes Mellitus , Heart Diseases , Hypertension , Phytotherapy/methods , Antioxidants
19.
Rev. Soc. Cardiol. Estado de Säo Paulo ; 29(2): 148-154, abr.-jun. 2019. graf
Article in Portuguese | LILACS (Americas) | ID: biblio-1009485

ABSTRACT

As doenças cardiovasculares continuam sendo a principal causa de morte no Brasil desde o final da década de 1960, a despeito da tendência de queda observada nos últimos anos. A mudança de estilo de vida relacionada à urbanização e globalização, com alta ingestão calórica e menor gasto energético, o rápido aumento da população idosa devido à maior expectativa de vida levaram à maior prevalência de obesidade e dislipidemias e, consequentemente, doenças cardiovasculares e metabólicas. Pesquisas de base populacional, estudos de coorte e de caso e de controle apontam para a importância do crescimento dos fatores de risco e diferenças regionais indicam que as políticas públicas e o atendimento médico devem priorizar intervenções de saúde tendo como objetivo a prevenção e controle dos fatores de risco mais prevalentes em nosso meio. A abordagem terapêutica da obesidade deve incluir não apenas a redução isolada do peso, e sim, atrelada à melhora metabólica ampla que se associe à diminuição do risco de complicações cardiovasculares. De um modo geral, a perda de peso é mais frequentemente alcançada ao longo dos primeiros meses ou do primeiro ano de exposição aos fármacos e embora alguns sejam mais efetivos, eventos adversos são frequentes, limitando o tratamento a longo prazo. O grande avanço e a maior segurança nos últimos anos vieram com o uso de medicamentos antiiperglicemiantes, como análogos de GLP-1, permitindo o uso a longo prazo com manutenção de resultados e adicionando benefícios cardiovasculares. A abordagem terapêutica das dislipidemias no paciente obeso é imperativa para a evolução desse perfil de pacientes, nos quais múltiplos fatores fisiológicos, bioquímicos, metabólicos e clínicos, estão interconectados e diretamente relacionados com aumentos substanciais do risco de diabetes, de doença aterosclerótica cardiovascular e mortalidade por todas as causas


Cardiovascular disease has been the no. 1 cause of death in Brazil since the late 1960s, despite the downtrend observed in recent years. Lifestyle changes related to urbanization and globalization, high calorie intake and lower energy expenditure, combined with a rapidly aging population due to increased life expectancy, have led to a greater prevalence of obesity and dyslipidemia, and consequently, cardiovascular and metabolic diseases. Population-based surveys, cohort and case-control studies underline the importance of the growth of risk factors, and regional differences indicate that public policies and medical care must prioritize health interventions in order to prevent and control the most prevalent risk factors in our country. The therapeutic approach to obesity must include not only weight reduction alone, but also in combination with comprehensive metabolic improvement, which is associated with a reduced risk of cardiovascular complications. In general, weight loss is more frequently achieved in the first few months or first year of exposure to medications, and although some drugs are more effective, adverse events are common, limiting treatment options to long-term therapy. The major advances and greater safety seen in recent years were achieved with the use of anti-hyperglycemic agents such as GLP-1 analogues, enabling long-term use with maintenance of results and adding cardiovascular benefits. The therapeutic approach to dyslipidemia in obese patients is imperative for the progress of this patient population, in which multiple physiological, biochemical, metabolic and clinical factors are interlinked and directly related to substantial increases in the risk of diabetes, atherosclerotic cardiovascular disease, and all-cause mortality


Subject(s)
Humans , Male , Female , Diet , Dyslipidemias/therapy , Obesity/prevention & control , Obesity/therapy , Time Factors , Brazil , Cardiovascular Diseases/mortality , Body Mass Index , Epidemiology , Prevalence , Risk Factors , Atherosclerosis , Overweight/complications , Life Style
20.
Int. j. cardiovasc. sci. (Impr.) ; 32(2): 163-176, mar.-abr. 2019. tab, graf
Article in English | LILACS (Americas) | ID: biblio-989991

ABSTRACT

Acute myocardial infarction (AMI) is less frequent in young individuals (≤ 45 years) than in older ones (> 45 years). Young AMI patients differ from older AMI patients in different ways. This article aims to assess the differences between young and older AMI patients. A search was made in the database of Cochrane Library, PubMed, BioMed Central and Embase, sence their establishment to December 2016, using the key words: risk factors, clinical characteristics, acute myocardial infarction and young. Meta-analysis was performed by using the Review Manager 5.3 software, pooled odds ratios and 95% confidence intervals were used to assess the strength of differences. Eight studies with fairly quality, enrolling 13,358 patients in the analysis. Compared with older AMI patients, young AMI patients had a higher rate of smoking and obesity (OR = 2.71,95%CI:1.87 to 3.92; OR = 1.76,95%CI:1.13 to 2.74), higher rate of family history of coronary artery disease and alcohol consumption (OR = 2.36,95%CI:1.22 to 4.59; OR = 1.76,95%CI:1.04 to 2.97). Moreover, Young AMI patients had a lower rate of hypertension and diabetes mellitus (OR = 0.52,95%CI:0.37 to 0.73; OR = 0.58,95%CI:0.50 to 0.67). No significant differences were observed in hyperlipidemia, a subgroup data-analysis showed a higher total cholesterol, triglyceride lipase, and low-density lipoprotein levels (p < 0.05), and lower levels of high-density lipoprotein (p < 0.01) in young AMI patients. Smoking, family history of coronary artery disease, obesity and alcohol consumption are the most main risk factors of AMI among young individuals, and young AMI patients have better prognosis than older ones


Subject(s)
Humans , Male , Female , Aged , Risk Factors , Myocardial Infarction/complications , Myocardial Infarction/mortality , Alcohol Drinking , Cardiovascular Diseases/complications , Cardiovascular Diseases/mortality , Smoking , Statistical Analysis , Age Factors , Coronary Angiography/methods , Meta-Analysis , Diabetes Mellitus , Young Adult , Hyperlipidemias , Hypertension , Obesity
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