ABSTRACT
The significance of the high-sensitivity C-reactive protein (hs-CRP) level in percutaneous coronary interventions (PCIs) is unclear. Troponin-T and hs-CRP levels were measured before PCI, after stenting, and 8 h, 24 h, and 30 days after the procedure in 68 consecutive patients who received bare-metal stents. The study endpoints were death, nonfatal myocardial infarction, and the need for revascularization. The mean follow-up time after PCI was 16.6 months. Patients who experienced an event had higher hs-CRP levels 24 h (P=.05) and 30 days (P< .02) after stenting. The area under the receiver operating characteristic (ROC) curve at 30 days had the highest sensitivity (i.e., 80%) and specificity (i.e., 72%) for predicting an event. The 12-month event-free survival rate (Kaplan-Meier) was greater when the hs-CRP level at 30 days was < or =2.5 mg/L than when it was above this value (P=.04). Consequently, measuring the hs-CRP level 30 days after stenting may be useful for predicting late events.
Subject(s)
C-Reactive Protein/analysis , Stents/adverse effects , Female , Humans , Male , Middle Aged , Postoperative Complications/epidemiology , Predictive Value of Tests , Prospective Studies , Prosthesis Design , Sensitivity and Specificity , Time FactorsABSTRACT
La proteína C reactiva de alta sensibilidad (PCR-as) tiene un valor incierto en el intervencionismo coronario percutáneo (ICP). En 68 pacientes consecutivos tratados con stents metálicos, se determinaron PCR-as y troponina T pre-ICP, post-stent, a las 8 h, a las 24 h y a los 30 días. Los objetivos finales fueron muerte, infarto de miocardio y nueva revascularización. El seguimiento medio post-ICP fue 16,6 meses. Los pacientes con eventos tuvieron PCR-as más alta a las 24 h (p = 0,05) y a los 30 días (p < 0,02). El área bajo la curva ROC de 30 días fue la más sensible (80%) y específica (72%) para predecir eventos. La supervivencia libre de eventos a los 12 meses fue superior cuando la PCR-as a los 30 días era <= 2,5 mg/l que cuando estuvo más elevada (p = 0,04). Por lo tanto, determinar PCR-as 30 días tras el ICP puede ser útil para predecir eventos tardíos
The significance of the high-sensitivity C-reactive protein (hs-CRP) level in percutaneous coronary interventions (PCIs) is unclear. Troponin-T and hs-CRP levels were measured before PCI, after stenting, and 8 h, 24 h, and 30 days after the procedure in 68 consecutive patients who received bare-metal stents. The study endpoints were death, nonfatal myocardial infarction, and the need for revascularization. The mean follow-up time after PCI was 16.6 months. Patients who experienced an event had higher hs-CRP levels 24 h (P=.05) and 30 days (P<.02) after stenting. The area under the receiver operating characteristic (ROC) curve at 30 days had the highest sensitivity (i.e., 80%) and specificity (i.e., 72%) for predicting an event. The 12-month event-free survival rate (Kaplan-Meier) was greater when the hs-CRP level at 30 days was <=2.5 mg/L than when it was above this value (P=.04). Consequently, measuring the hs-CRP level 30 days after stenting may be useful for predicting late events
Subject(s)
Humans , C-Reactive Protein/analysis , Angioplasty, Balloon, Coronary/adverse effects , Biomarkers/analysis , Postoperative Complications/diagnosis , Stents/adverse effectsABSTRACT
Data on the long-term prognosis of acute myocardial infarction (AMI) in young patients are limited. This study investigated long-term survival and risk predictors in a series of 108 consecutive patients
Subject(s)
Myocardial Infarction , Adult , Age Factors , Female , Humans , Male , Myocardial Infarction/diagnosis , Myocardial Infarction/epidemiology , Myocardial Infarction/therapy , Prognosis , Prospective Studies , Time FactorsABSTRACT
Because of the absence of a uniform protocol for the head-up tilt table test (HUT), we compared 1,661 consecutive patients with syncope referred for HUT. The influence of age and gender on the results (positive response rate and patterns) obtained with three different protocols, Westminster, isoprenaline and nitroglycerin (groups A, B and C) was analyzed. The proportion of women was larger in the youngest age group. A positive response to HUT was observed in 592 patients. The positive response rate to the HUT was higher in groups B and C than in group A, and the rate diminished with age in groups A and C, because of the decrease in mixed-positive responses, but not in group B. The rate of positive responses was similar in groups A and C, but different in group B; no influence of gender on these results was observed. The results with the Westminster and nitroglycerin protocols were similar, but the rate of positive responses was higher in the latter.
Subject(s)
Syncope/diagnosis , Tilt-Table Test , Adult , Clinical Protocols , Female , Humans , Male , Middle AgedABSTRACT
BACKGROUND AND OBJECTIVE: The prevalence and morbidity of the vaso-vagal syncope are well-known. With the intention of measuring the Quality of Life (QoL) of patients with vaso-vagal syncope, as well as age and gender influence, we have used the Spanish version of Short form 36 (SF-36) questionnaire in those patients and have compared it with the general population and with patients with heart failure. PATIENTS AND METHOD: All consecutive patients with vaso-vagal syncope submitted for head-up tilt test performance from January 2001 to December 2002 were included. SF-36 was self-administered prior to the head-up tilt test. RESULTS: Two hundred and seventy one patients were included (50.5% females). In these patients, QoL scores were lower than those of the Spanish general population and similar to those in patients with heart failure. Women's scores were lower in eight dimensions, and only four were lower in men's. Women QoL was worst than men's (p < 0.05). Age had a negative influence on the eight dimensions of SF-36, especially in women. The number of syncopes was the most influential clinic parameter on the QoL of such patients. CONCLUSIONS: In our series, patients suffering from vaso-vagal syncope had a poor QoL when compared with heart failure or control populations. Women had lower QoL than men, and there was an age-related worsening in both men and women. Our data show that the number of syncopes is the clinic parameter having the best correlation with QoL.
Subject(s)
Activities of Daily Living , Quality of Life , Syncope, Vasovagal/psychology , Adolescent , Adult , Aged , Female , Health Status Indicators , Humans , Male , Middle Aged , Personal Satisfaction , Surveys and Questionnaires , Syncope, Vasovagal/diagnosis , Syncope, Vasovagal/therapy , Tilt-Table TestABSTRACT
FUNDAMENTO Y OBJETIVO: Son conocidas la prevalencia del síncope vasovagal y su morbilidad. Con objeto de cuantificar la calidad de vida relacionada con la salud (CVRS) de los pacientes que lo sufren y evaluar la influencia de la edad y el sexo, se compararon los resultados obtenidos tras la administración de la versión española del Cuestionario de Salud SF-36 en esta población con los valores de la población general y de pacientes con insuficiencia cardíaca. Además se ha analizado la influencia de diversos parámetros clínicos. PACIENTES Y MÉTODO: Se incluyó consecutivamente a todos los pacientes con síncope vasovagal sometidos a test de tabla basculante desde enero de 2001 hasta diciembre de 2002. El cuestionario se contestó previamente a la realización del test. Se calcularon los valores utilizando estadísticos apropiados a la distribución de la muestra, se analizaron según la edad y el sexo, y se correlacionaron con diversos parámetros clínicos. RESULTADOS: Se incluyó a 271 pacientes (50,5 por ciento mujeres). La CVRS en estos pacientes fue inferior a los valores poblacionales y similar a la de los pacientes que sufren insuficiencia cardíaca. En el varón sólo 4 dimensiones del SF-36 fueron inferiores a la población general, y en la mujer lo fueron las 8. La mujer tuvo peor percepción de su CVRS que el varón (p < 0,05). La edad influyó negativamente en todas las dimensiones del SF-36, sobre todo en la mujer. El número de síncopes fue el parámetro clínico que más se relacionó con la CVRS.CONCLUSIONES: En nuestra serie, los pacientes con síncope vasovagal tienen peor CVRS respecto a la población general de referencia y similar a la que sufre insuficiencia cardíaca. La CVRS es peor en la mujer y empeora con la edad en ambos sexos. Nuestra serie indica que el número de síncopes es el parámetro clínico que mejor se correlaciona con la CVRS (AU)
Subject(s)
Middle Aged , Adult , Adolescent , Aged , Male , Female , Humans , Quality of Life , Activities of Daily Living , Syncope, Vasovagal , Personal Satisfaction , Surveys and Questionnaires , Health Status Indicators , Tilt-Table TestABSTRACT
Ante la ausencia de un protocolo estandarizado y único, presentamos un análisis de 1.661 pacientes consecutivos remitidos para estudio con test de tabla basculante (TTB) desde septiembre de 1990 y analizamos la influencia de la edad y el sexo en sus resultados utilizando 3 protocolos: Westminster, isoproterenol y nitroglicerina (grupos A, B y C). La proporción de mujeres es mayor en el grupo de menor edad. El TTB fue positivo en 592 pacientes. El porcentaje de respuestas positivas (RP) fue más bajo en el grupo A que en los grupos B y C. En los grupos A y C, éste se redujo con la edad a expensas de las RP mixtas, pero no en el grupo B. Los porcentajes de cada tipo de RP son similares en los grupos A y C, y diferentes en el grupo B, sin que el sexo influya en este resultado. Existe una gran similitud entre los protocolos A y C, pero este último obtiene un mayor porcentaje de RP (AU)
