ABSTRACT
Atrial fibrillation (AF) is the most common arrhythmia in adults. Prevention of the ischaemic risk with oral anticoagulants (OACs) is widely recommended, and current clinical guidelines recommend direct oral anticoagulants (DOACs) as preference therapy for stroke prevention. However, there are currently no clinical practice guidelines or recommendation documents on the optimal management of OACs in patients with AF that specifically address and adapt to the Central American and Caribbean context. The aim of this Delphi-like study is to respond to doubts that may arise in the management of OACs in patients with non-valvular AF in this geographical area. A consensus project was performed on the basis of a systematic review of the literature, a recommended ADOLOPMENT-like approach, and the application of a two-round Delphi survey. In the first round, 31 recommendations were evaluated and 30 reached consensus, of which, 10 unanimously agreed. The study assessed expert opinions in a wide variety of contextualized recommendations for the optimal management of DOACs in patients with non-valvular atrial fibrillation (NVAF). There is a broad consensus on the clinical practice guideline (CPG) statements used related to anticoagulation indication, patient follow-up, anticoagulation therapy complications, COVID-19 management and prevention, and cardiac interventions.
ABSTRACT
Growing scientific evidence from studies on type 2 diabetes (T2D) has recently led to a better understanding of the associated metabolic-cardio-renal risks. The large amount of available information makes it essential to have a practical guide that summarizes the recommendations for the initial management of patients with T2D, integrating different aspects of endocrinology, cardiology, and nephrology. The expert consensus presented here does not attempt to summarize all the evidence in this regard but rather attempts to define practical summary recommendations for the primary care physician to improve the clinical prognosis and management of patients with T2D, while ensuring economic sustainability of health systems, beyond glycemic control.
Subject(s)
Acute Coronary Syndrome/therapy , Cardiopulmonary Resuscitation/standards , Emergency Medical Services/standards , Acute Coronary Syndrome/diagnosis , Acute Coronary Syndrome/drug therapy , Cardiac Catheterization/methods , Cardiac Catheterization/standards , Cardiopulmonary Resuscitation/methods , Diagnosis, Computer-Assisted , Electrocardiography , Emergency Medical Services/methods , Fibrinolytic Agents/therapeutic use , First Aid/standards , Humans , Percutaneous Coronary Intervention , Thrombolytic Therapy/methods , Thrombolytic Therapy/standardsABSTRACT
En los últimos años se han redoblado los esfuerzos para disminuir y en el mejor de los casos evitar el daño al músculo cardíaco durante el infarto agudo. Las drogas trombolíticas han contribuido positivamente al respecto. Sin embargo, nace la necesidad de buscar formas alternas de tratamiento que proporcionen un más rápido y efectivo restablecimiento de la circulación coronaria. Nos referimos a la Angioplastía Primaria como tratamiento inicial del infarto agudo. Presentamos los primeros 16 casos con infarto agudo al miocardio en curso, tratados con Angioplastía Primaria, 15 de 16 pacientes evolucionaron en forma satisfactoria, sin complicaciones del infarto que al procedimiento de angioplastía per-se. De esta manaera reafirmamos la utilidad de esta nueva forma de tratamiento, planteando una alternativa terapéutica adicional en beneficio de los pacientes que están sufriendo un infarto agudo al miocardio.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Angioplasty , Myocardial Infarction , PanamaABSTRACT
El Balón de contrapulsación Intra-aórtico (B.C.I.A.)es un equipo auxiliar de soporte cardiocirculatorio, cuya correcta indicación y utilización le proporcionará ...
Subject(s)
Humans , Male , Female , Middle Aged , Heart Diseases , Hemodynamics , Intra-Aortic Balloon Pumping , Ischemia/surgery , Ischemia/therapy , Myocardial Revascularization , PanamaSubject(s)
Humans , Adenosine , Cardiology , Cardiovascular Diseases/diagnosis , Dipyridamole , Perfusion , Sensitivity and Specificity , Technetium Tc 99m Sestamibi , Thallium , PanamaABSTRACT
El papel de las plaquetes en la protegénesis de los síndromes coronarios agudos es cada vez más evidente. El manejo farmacológico de los mismos era inicialmente orientado a contrarestar un proceso trombotico fibrino-específico sin considerarse la importante participación de las plaquetas en la fisiopatología de los mismos. Desde 1994 se integran al tratamiento los inhibidores de las glicoproteínas IIb IIIa como antiplaquetarios específicos, obteniéndose una discriminación significativa en la morbi-mortalidad cardio vascular. Queremos presentar nuestra experincia preliminar con el uso de estos fármacos en pacientes de alto riesgo
