RESUMO
UNLABELLED: Introduction and subject: The aim of the study was to determine the factors involved in the delayed medical care of patients with ST-Segment Elevation Myocardial Infarction. METHODS: A prospective observational study was conducted in patients admitted to the coronary care unit at Dr. Juan Graham Casasús hospital with a diagnosis of ST-Segment Elevation Acute Myocardial Infarction. In all patients, clinical data, type and time of reperfusion treatment, and factors associated with delay were identified. RESULTS: Between November 2012 and January 2015 we included 213 patients with ST-Segment Elevation Myocardial Infarction. Age, diabetes, atypical chest angina and patient arrival period (night or weekend), were more frequent in patients presenting after 12 hours of onset of symptoms of myocardial infarction. Of these, hospital admission at night or weekend was the only independent predictor for delay to the emergency room. CONCLUSIONS: This study shows that in a referral hospital in southeast of Mexico, the delay attributable to the patient was the most common factor associated with care in patients with ST-Segment Elevation Myocardial Infarction. Patient arrival period was associated with delay to medical care.
Assuntos
Reperfusão Miocárdica/métodos , Admissão do Paciente/estatística & dados numéricos , Infarto do Miocárdio com Supradesnível do Segmento ST/terapia , Idoso , Unidades de Cuidados Coronarianos , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Masculino , México , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores de TempoRESUMO
It is widely acknowledged that cardiovascular heart disease (CHD) has a genetic influence. Several studies have investigated the role of inflammatory markers like C-reactive protein (CRP) and tumor necrosis factor α (TNF-α) in the causation of cardiovascular diseases. Although there have been several positive studies associating CRP and TNF-α genes with CHD, the evidence is not entirely consistent. Therefore, we performed a meta-analysis to gain a better understanding into this issue. The meta-analysis was conducted with 22 articles of genetic association studies of CRP (G1059C rs1800947, C1444T rs1130864, C717T rs2794521 and G3872A rs1205) and TNF-α (C857T rs1799724, C863A rs1800630 and T1031C rs1799964) genes. To analyze the association of these variants with CHD we used the following models: allelic, additive, dominant and recessive. In addition, we performed a sub-group analysis by Caucasian population using the same four models. CRP and TNF-α gene polymorphisms showed a positive significant association with CHD. This study provides evidence that rs2794521 of the CRP gene and rs1799724, rs1800630 and rs1799964 of the TNF-α gene polymorphisms may be risk factors to manifest CHD. The analysis of rs1800947 and rs1205 of the CRP gene yielded a protective effect in the pathogenesis of this disease. Only the analysis of the rs1130864 polymorphism showed a lack of association with CHD. To have conclusive outcomes it is necessary to integrate more studies to confirm our findings.
RESUMO
BACKGROUND: Genetic factors play an important role in the pathogenesis of coronary heart disease (CHD). Kinesin-like protein 6 (KIF6) is a new candidate gene for CHD, since it has been identified as a potential risk factor. The aim of this study was to perform a systematic review and meta-analysis of previously published association studies between the Trp719Arg polymorphism of KIF6 and the development of CHD. METHODS: Studies and abstracts investigating the relationship between the Trp719Arg polymorphism of KIF6 and subsequent risk for development of CHD were reviewed. Electronic search from Pubmed and EBSCO databases was performed between 1993 and 2014 to identify studies that fulfilled the inclusion criteria. To analyze the association we used the models: allelic, additive, dominant and recessive. Moreover, we conducted a sub-analysis by populations using the same four models. RESULTS: Twenty-three studies were included in the meta-analysis. The Trp719Arg polymorphism showed a significant association with CHD when the analysis comprised the population with myocardial infarction (MI) and the additive genetic model was used. Moreover, this polymorphism showed a protective association with CHD when the analysis comprised the whole population using the recessive genetic model. CONCLUSIONS: Our findings indicate that the Trp719Arg polymorphism of the KIF6 gene is an important risk factor for developing MI and that allele 719Arg may have a protective association to present CHD in all populations. PROSPERO REGISTRATION: CRD42015024602.
