ABSTRACT
En los últimos años, el número de pacientes anticoagulados y antiagregados está aumentando significativamente. Al ser un tratamiento crónico, es de esperar que a lo largo de su vida necesiten un procedimiento quirúrgico o intervencionista que pueda requerir la interrupción del fármaco antitrombótico. La decisión de retirar o mantener dicho tratamiento estará determinada, por un lado, por el riesgo trombótico y, por otro, por el hemorrágico. De la interacción entre estos 2 factores dependerá la actitud ante la anticoagulación y la antiagregación. El objetivo de este documento de consenso, coordinado desde el Grupo de Trabajo de Trombosis Cardiovascular de la Sociedad Española de Cardiología y certificado por un amplio número de sociedades científicas que participan en el proceso asistencial del paciente durante el periodo perioperatorio o periprocedimiento, consiste en proponer una serie de recomendaciones prácticas y sencillas con el fin de homogeneizar la práctica clínica diaria
During the last few years, the number of patients receiving anticoagulant and antiplatelet therapy has increased worldwide. Since this is a chronic treatment, patients receiving it can be expected to need some kind of surgery or intervention during their lifetime that may require treatment discontinuation. The decision to withdraw antithrombotic therapy depends on the patient's thrombotic risk versus hemorrhagic risk. Assessment of both factors will show the precise management of anticoagulant and antiplatelet therapy in these scenarios. The aim of this consensus document, coordinated by the Cardiovascular Thrombosis Working Group of the Spanish Society of Cardiology, and endorsed by most of the Spanish scientific societies of clinical specialities that may play a role in the patient-health care process during the perioperative or periprocedural period, is to recommend some simple and practical guidelines with a view to homogenizing daily clinical practice
Subject(s)
Humans , Thrombosis/prevention & control , Fibrinolytic Agents/administration & dosage , Anticoagulants/administration & dosage , Platelet Aggregation Inhibitors/administration & dosage , Thromboembolism/prevention & control , Perioperative Period , Withholding Treatment , Practice Patterns, Physicians'ABSTRACT
During the last few years, the number of patients receiving anticoagulant and antiplatelet therapy has increased worldwide. Since this is a chronic treatment, patients receiving it can be expected to need some kind of surgery or intervention during their lifetime that may require treatment discontinuation. The decision to withdraw antithrombotic therapy depends on the patient's thrombotic risk versus hemorrhagic risk. Assessment of both factors will show the precise management of anticoagulant and antiplatelet therapy in these scenarios. The aim of this consensus document, coordinated by the Cardiovascular Thrombosis Working Group of the Spanish Society of Cardiology, and endorsed by most of the Spanish scientific societies of clinical specialities that may play a role in the patient-health care process during the perioperative or periprocedural period, is to recommend some simple and practical guidelines with a view to homogenizing daily clinical practice.
Subject(s)
Anticoagulants/therapeutic use , Fibrinolytic Agents/therapeutic use , Hemorrhage/etiology , Platelet Aggregation Inhibitors/therapeutic use , Thromboembolism/etiology , Aged , Aged, 80 and over , Drug Substitution , Female , Hemorrhage/prevention & control , Humans , Intraoperative Care/methods , Male , Preoperative Care/methods , Risk Assessment , Risk Factors , Thromboembolism/prevention & controlSubject(s)
Neoplasms/complications , Pulmonary Embolism/therapy , Venous Thromboembolism/therapy , Venous Thrombosis/therapy , Anticoagulants/therapeutic use , Combined Modality Therapy , Fibrinolytic Agents/therapeutic use , Humans , Neoplasms/diagnosis , Primary Prevention/methods , Prognosis , Pulmonary Embolism/diagnosis , Pulmonary Embolism/etiology , Risk Factors , Vena Cava Filters , Venous Thromboembolism/diagnosis , Venous Thromboembolism/etiology , Venous Thrombosis/diagnosis , Venous Thrombosis/etiologyABSTRACT
No disponible
Subject(s)
Humans , Venous Thromboembolism/drug therapy , Neoplasms/complications , Fibrinolytic Agents/therapeutic use , Anticoagulants/therapeutic use , Risk Factors , Life Expectancy , Evidence-Based Medicine , Neoplasms, Unknown Primary/diagnosis , Premedication/methods , Vena Cava Filters , Venous Thrombosis/epidemiologySubject(s)
Aneurysm/complications , Aneurysm/surgery , Cardiovascular Abnormalities/complications , Cardiovascular Abnormalities/surgery , Deglutition Disorders/etiology , Endovascular Procedures , Deglutition Disorders/complications , Deglutition Disorders/surgery , Humans , Male , Middle Aged , Subclavian Artery/abnormalities , Subclavian Artery/surgery , Vascular Surgical Procedures/methodsABSTRACT
Because of the increase in life expectancy, peripheral artery disease (PAD) has become a major health problem. A study performed in Spain in persons aged more than 65 years old found an overall prevalence of PAD of 9.9%. The most important risk factors for PAD were smoking, diabetes mellitus, advanced age, hyperlipidemia and hypertension. Treatment includes smoking cessation, exercise, statins, platelet antiaggregants, cilostazol or hemorheologic agents, and revascularization techniques. Data from the Spanish arm of REACH indicate that the PAD subgroup shows the poorest control of blood pressure and cholesterol and that use of platelet antiaggregants and statins is lowest in these patients, indicating that therapeutic and preventive strategies are not being correctly applied.
Subject(s)
Atherosclerosis/prevention & control , Myocardial Infarction/prevention & control , Registries , Stroke/prevention & control , Thrombosis/prevention & control , Vascular Diseases/surgery , Vascular Surgical Procedures , Aged , Female , Humans , Male , Vascular Diseases/complicationsABSTRACT
El aumento de la expectativa de vida ha conducido a que la enfermedad arterial periférica (EAP) se haya constituido en un problema de salud. En un estudio realizado en España en mayores de 65 años se obtuvo una prevalencia global de la EAP del 9,9%. Los factores de riesgo mayores para la EAP son el consumo de tabaco, la diabetes mellitus, la edad avanzada, la hiperlipidemia y la hipertensión. El tratamiento incluye el abandono del tabaco, el ejercicio, las estatinas, los antiagregantes plaquetarios, el cilostazol o los hemorreológicos, y las técnicas de revascularización. Conforme a los datos del REACH España, los pacientes del subgrupo de EAP son los que tienen peor controlada la presión arterial y el colesterol, y en los que se usan menos los antiagregantes plaquetarios y las estatinas, por lo que se puede concluir que no se están aplicando correctamente las estrategias terapéuticas y preventivas (AU)
Because of the increase in life expectancy, peripheral artery disease (PAD) has become a major health problem. A study performed in Spain in persons aged more than 65 years old found an overall prevalence of PAD of 9.9%. The most important risk factors for PAD were smoking, diabetes mellitus, advanced age, hyperlipidemia and hypertension. Treatment includes smoking cessation, exercise, statins, platelet antiaggregants, cilostazol or hemorheologic agents, and revascularization techniques. Data from the Spanish arm of REACH indicate that the PAD subgroup shows the poorest control of blood pressure and cholesterol and that use of platelet antiaggregants and statins is lowest in these patients, indicating that therapeutic and preventive strategies are not being correctly applied (AU)
Subject(s)
Aged , Female , Humans , Male , Vascular Diseases/surgery , Arteriosclerosis/prevention & control , Myocardial Infarction/prevention & control , Registries , Stroke/prevention & control , Thrombosis/prevention & control , Vascular Surgical Procedures , Vascular Diseases/complicationsABSTRACT
Introducción. El aumento de la expectativa de vida ha conducido a que patologías vasculares, especialmente prevalentes en el segmento de población con más edad, se hayan constituido en problemas de salud. Objetivo. Determinar la prevalencia de la isquemia crónica (IC) y de los aneurismas de aorta abdominal (AAA) infrarrenal en la población mayor de 65 años del Área Sanitaria V (Gijón) del Servicio de Salud del Principado de Asturias. Pacientes y métodos. Se diseña un estudio descriptivo transversal, incluyendo finalmente 232 pacientes, 114 hombres y 118 mujeres, seleccionados aleatoriamente a partir de los datos de la tarjeta sanitaria. Se les explora, se realiza un eco-Doppler de la aorta abdominal y se calcula el índice tobillo-brazo. Resultados. La prevalencia de la IC es del 9,9% y de un 2,6% para el AAA. Se desagregan los resultados por sexos y dos grupos de edad, de 65-74 años y mayores de 75. La prevalencia de la IC está seis puntos por encima en el grupo de los mayores de 75 años (13,4%) y la del AAA es más de siete veces superior (5,2%). Conclusión. La prevalencia es más elevada en los mayores de 75 años y los varones para la IC y el AAA, con diferencias estadísticamente significativas. Este estudio abre las puertas a un seguimiento de los integrantes de la muestra, que permita determinar la incidencia de las diversas patologías
Introduction. As life expectancy has increased, vascular pathologies, which are especially prevalent in the most elderly segment of the population, have become a health problem. Aim. To determine the prevalence of chronic ischaemia (CI) and infrarenal abdominal aortic aneurysms (AAA) in a population of persons over 65 years of age from Health Care District V (Gijón) of the Principality of Asturias Health Service. Patients and methods. A cross-sectional descriptive study was designed, which finally included 232 patients (114 males and 118 females) who were selected at random from the data contained in their health card. They were examined, submitted to a Doppler ultrasound scan of the abdominal aorta and their ankle-brachial index was calculated. Results. The prevalence of CI was found to be 9.9% and 2.6% for AAA. Results were broken down by sexes and two age groups: 65-74 years and over 75 years of age. The prevalence of CI was six points higher in the group of over 75s (13.4%) and that of AAA was seven times higher (5.2%). Conclusions. For CI and AAA, prevalence was higher in persons over 75 years old and males, with statistically significant differences. This study opens the way to a follow-up of the participants in the sample, which would allow us to determine the incidence of several different pathologies
