[Changes in percutaneous coronary intervention over the last 20 years: demographic, epidemiologic and clinical characteristics, techniques, and outcomes]. / Evolución en los últimos 20 años en el perfil demográfico, epidemiológico y clínico, técnica y resultados de los procedimientos coronarios percutáneos.

INTRODUCTION AND OBJECTIVES: The aim of this study was to describe the changes observed in clinical practice in our interventional cardiology unit over the last 20 years. METHODS: Between January 1, 1986 and December 31, 2005, >or=17,204 percutaneous transluminal coronary angioplasties (PTCAs) were performed at our center. They were analyzed in four periods of 5 years each. After each procedure, prospective data on patient, procedural, and outcome variables were recorded. The data were analyzed with regard to when the procedure was performed, and the patients' sex and age (i.e., < or >or=75 years). Data from 2006 were used as a reference, but were not included in the analysis. RESULTS: The number of PTCAs increased significantly. Over the time period, mean patient age increased (from 57[10] years to 62[12] years for males and from 66[10] years to 70[11] years for females), and there were significant increases in the proportions of women (from 16% to 22%) and patients aged >75 years (from 7% to 22%). Among men, the incidence of smoking decreased while that of hypertension, diabetes and hyperlipemia increased. Among women, however, there was no change in risk factors. The numbers of urgent and emergent procedures (17% of PTCAs were for acute myocardial infarction in 2006) increased in both sexes and age groups, more ad hoc procedures were carried out, and more lesions were treated, usually with a stent. Over time, the success rate increased and the complication rate decreased in both sexes and age groups. In-hospital mortality for all procedures, except those for acute myocardial infarction, was 0.7% in males and 1.4% in females (P=.012). CONCLUSIONS: Significant changes were observed over the last 20 years in the baseline characteristics of, the techniques used in, and the outcomes obtained in patients undergoing percutaneous coronary intervention.

Evolución en los últimos 20 años en el perfil demográfico, epidemiológico y clínico, técnica y resultados de los procedimientos coronarios percutáneos / Changes in percutaneous coronary intervention over the last 20 years: demographic, epidemiologic and clinical characteristics, techniques, and outcomes

Introducción y objetivos. Describir los cambios observados en la actividad clínica de nuestra unidad de cardiología intervencionista en los últimos 20 años. Métodos. Desde el 1 de enero de 1986 al 31 de diciembre de 2005 se realizaron en nuestro centro 17.204 angioplastias (ACTP), que se han dividido en 4 períodos de 5 años cada uno. Tras cada intervención y de forma prospectiva se recogieron una serie de variables relacionadas con el paciente, la intervención y su resultado. Se describen estas variables y se analizan de acuerdo con el período de realización de la intervención, el sexo y el grupo de edad (< o ≥ 75 años) del paciente. Como referencia, y sin que forme parte del análisis, se incluyen los datos de 2006. Resultados. El número de ACTP ha aumentado de forma significativa. En este tiempo se ha incrementado la edad de los pacientes (de 57 ± 10 a 62 ± 12 años en los varones y de 66 ± 10 a 70 ± 11 años en las mujeres), con un aumento (del 16 al 22%) en el porcentaje de mujeres y de mayores de 75 años (del 7 al 22%). En los varones se ha observado una reducción del tabaquismo y un aumento de la hipertensión arterial, la diabetes y la hiperlipemia, mientras que en las mujeres no se han modificado los factores de riesgo. Ha aumentado el número de procedimientos urgentes y emergentes (un 17% de ACTP en el infarto agudo de miocardio en 2006) en ambos sexos y grupos de edad, se realizan más ACTP ad hoc y se tratan más lesiones, generalmente con stent. La tasa de éxito se ha incrementado con el tiempo y la de complicaciones ha disminuido para ambos sexos y grupos de edad. La mortalidad intrahospitalaria de los procedimientos fuera del infarto agudo de miocardio fue en 2006 del 0,7% para los varones y del 1,4% para las mujeres (p = 0,012). Conclusiones. Se documentan cambios importantes en las características basales, la técnica realizada y los resultados obtenidos en pacientes con intervencionismo coronario (AU)

Introduction and objectives. The aim of this study was to describe the changes observed in clinical practice in our interventional cardiology unit over the last 20 years. Methods. Between January 1, 1986 and December 31, 2005, é17 204 percutaneous transluminal coronary angioplasties (PTCAs) were performed at our center. They were analyzed in four periods of 5 years each. After each procedure, prospective data on patient, procedural, and outcome variables were recorded. The data were analyzed with regard to when the procedure was performed, and the patients' sex and age (i.e., 75 years (from 7% to 22%). Among men, the incidence of smoking decreased while that of hypertension, diabetes and hyperlipemia increased. Among women, however, there was no change in risk factors. The numbers of urgent and emergent procedures (17% of PTCAs were for acute myocardial infarction in 2006) increased in both sexes and age groups, more ad hoc procedures were carried out, and more lesions were treated, usually with a stent. Over time, the success rate increased and the complication rate decreased in both sexes and age groups. In-hospital mortality for all procedures, except those for acute myocardial infarction, was 0.7% in males and 1.4% in females (P=.012). Conclusions. Significant changes were observed over the last 20 years in the baseline characteristics of, the techniques used in, and the outcomes obtained in patients undergoing percutaneous coronary intervention (AU)

[Advances in geriatric cardiology]. / Avances en cardiología geriátrica.

The continued aging of the population is an acknowledged fact. The proportion of individuals in the European Union aged over 65 years will reach 29.9% by 2050, almost double the present figure of 16.4%. Approximately one third of people in this age-group has clinically significant cardiovascular disease. Physicians dealing with cardiology in older patients have to be aware of the specific clinical and prognostic features of cardiovascular disease in the elderly, and with its treatment. Consequently, it is clear that continuing medical education in geriatric cardiology is essential, and that is one of the tasks of the Working Group on Geriatric Cardiology. This special issue provides a magnificent opportunity for presenting an update on important topics in geriatric cardiology, such as the aging of the cardiovascular system, heart failure, and atrial fibrillation.

Avances en cardiología geriátrica / Advances in Geriatric Cardiology

El continuo envejecimiento de la población es una auténtica realidad. La media de personas de más de 65 años en la Unión Europea alcanzará el 29,9% en 2050, casi el doble del 16,4% que hay en la actualidad. Aproximadamente, un tercio de personas en esta edad tiene enfermedad cardiovascular clínica. Los médicos responsables del paciente cardiópata anciano deben estar familiarizados con las diferentes manifestaciones clínicas, pronósticas y de manejo de las enfermedades cardiovasculares en la senectud. Así, la necesidad de continuar la educación médica en cardiología geriátrica es evidente en sí, y ése es uno de los cometidos de la sección de cardiología geriátrica. Este número extraordinario de la revista es una magnifica oportunidad para actualizar aspectos importantes de la cardiología geriátrica, como el envejecimiento cardiovascular, la insuficiencia cardíaca y la fibrilación auricular (AU)

The continued aging of the population is an acknowledged fact. The proportion of individuals in the European Union aged over 65 years will reach 29.9% by 2050, almost double the present figure of 16.4%. Approximately one third of people in this age-group has clinically significant cardiovascular disease. Physicians dealing with cardiology in older patients have to be aware of the specific clinical and prognostic features of cardiovascular disease in the elderly, and with its treatment. Consequently, it is clear that continuing medical education in geriatric (..) (AU)