Estudio de la rigidez arterial en pacientes con un evento coronario agudo y enfermedad pulmonar obstructiva crónica confirmada por espirometría / Study of arterial stiffness in patients with an acute coronary event and chronic obstructive pulmonary disease confirmed by spirometry

Antecedentes y objetivos: La enfermedad pulmonar obstructiva crónica (EPOC) empeora el pronóstico de los pacientes con un evento coronario agudo (ECA) tratado con intervención coronaria percutánea. Objetivo: evaluar el efecto de la EPOC sobre la rigidez arterial en pacientes con un ECA. Métodos: Pacientes con un ECA tratado con intervención coronaria percutánea. Al mes se realizó una espirometría posbroncodilatación y se determinó la rigidez arterial y marcadores de daño miocárdico (troponina T y ProBNP). Resultados: Se incluyeron 68 pacientes, de los cuales un 33% tenían EPOC (59% no diagnosticados). Los pacientes con EPOC presentaron valores más altos de rigidez arterial tras ajustar por edad y cifras tensionales. Los niveles de troponina T y ProBNP fueron más altos en los pacientes con EPOC. Conclusiones: La rigidez arterial es mayor en los pacientes con un ECA si tienen EPOC concomitante. Estos hallazgos pueden ayudar a explicar el peor pronóstico de los pacientes con ambas patologías

Background and objectives: Chronic obstructive pulmonary disease (COPD) worsens the prognosis for patients with an acute coronary event (ACE) treated with percutaneous coronary intervention. Objective To assess the effect of COPD on arterial stiffness in patients with an ACE. Methods: The study included patients with an ACE treated with percutaneous coronary intervention. At 1 month, postbronchodilation spirometry was performed, and arterial stiffness and markers of myocardial damage (troponin T and ProBNP) were measured. Results: We included 68 patients, 33% of whom had COPD (59% undiagnosed). The patients with COPD presented higher arterial stiffness values after adjusting for age and blood pressure readings. The troponin T and ProBNP levels were higher in the patients with COPD. Conclusions: Arterial stiffness is greater in patients with an ACE if they have concomitant COPD. These findings can help explain the poorer prognosis of patients with both conditions

Study of arterial stiffness in patients with an acute coronary event and chronic obstructive pulmonary disease confirmed by spirometry. / Estudio de la rigidez arterial en pacientes con un evento coronario agudo y enfermedad pulmonar obstructiva crónica confirmada por espirometría.

BACKGROUND AND OBJECTIVES: Chronic obstructive pulmonary disease (COPD) worsens the prognosis for patients with an acute coronary event (ACE) treated with percutaneous coronary intervention. Objective To assess the effect of COPD on arterial stiffness in patients with an ACE. METHODS: The study included patients with an ACE treated with percutaneous coronary intervention. At 1 month, postbronchodilation spirometry was performed, and arterial stiffness and markers of myocardial damage (troponin T and ProBNP) were measured. RESULTS: We included 68 patients, 33% of whom had COPD (59% undiagnosed). The patients with COPD presented higher arterial stiffness values after adjusting for age and blood pressure readings. The troponin T and ProBNP levels were higher in the patients with COPD. CONCLUSIONS: Arterial stiffness is greater in patients with an ACE if they have concomitant COPD. These findings can help explain the poorer prognosis of patients with both conditions.

[Comparison of the effectiveness of two different pharmacologic approaches to prevent intraoperative floppy iris syndrome]. / Comparación de la efectividad de dos estrategias farmacológicas para la prevención del síndrome de iris flácido intraquirúrgico.

OBJECTIVE: To compare the effectiveness of two strategies to prevent the appearance of intraoperative floppy iris syndrome (IFIS) in patients exposed to a-blockers. METHODS: We compared retrospectively the presence and severity of the appearance of IFIS in 29 patients subjected to cataract surgery, establishing two groups of 12 patients (22 eyes) and 17 patients (33 eyes). The strategy applied to group one consisted of suspending the exposure to a-blockers for at least one week prior to the intervention, the topical application of 1% atropine three times a day for two days before the intervention and the use of intracameral lidocaine. The strategy for group two consisted of suspending use of the drug for at least one week before the intervention and the intracameral application at the beginning of surgery of a solution of physiological serum, adrenaline and lidocaine. RESULTS: Six patients from group one showed no evidence of IFIS, 2 exhibited bilateral mild symptoms, 2 bilateral moderate and 2 unilateral severe symptoms of IFIS. In total, 45.5% eyes suffered from IFIS. In group two, only 3 eyes (9.1%) from 2 patients exhibited mild symptoms. Statistical analysis showed a significant difference between both groups (p=0.002). If only those exhibiting moderate and severe symptoms are taken into account the result was highly statistically significant (p=0.0002). CONCLUSION: The study shows a greater statistical effectiveness of the strategy applied to group two compared to the strategy applied to group one (Arch Soc Esp Oftalmol 2009; 84: 549-556).

Comparación de la efectividad de dos estrategias farmacológicas para la prevención del síndrome de iris flácido intraquirúrgico / Comparison of the effectiveness of two different pharmacologic approaches to prevent intraoperative floppy iris syndrome

Objetivo: Comparar la efectividad de dos estrategiasdiseñadas para prevenir la aparición del síndromede iris flácido intraquirúrgico (IFIS) en pacientesexpuestos a α-bloqueantes.Métodos: Comparamos retrospectivamente la presenciay severidad de aparición del síndrome en 29pacientes intervenidos de cataratas, estableciendodos grupos de 12 pacientes (22 ojos) y 17 pacientes(33 ojos). La estrategia aplicada al grupo uno consistióen suspender le exposición a los α-bloqueantesun mínimo de una semana antes de la intervención,atropina tópica 1% 3 veces al día desde dosdías antes, y adrenalina intracamerular. La estrategiadel grupo dos fue la suspensión del fármaco unmínimo de una semana antes y la aplicación intracamerularal inicio de la cirugía de una solución formadapor suero fisiológico, adrenalina y lidocaína.Resultados: En el grupo uno 6 pacientes no tuvieronIFIS, 2 padecieron IFIS leve bilateral, 2 moderadobilateral y 2 severo (unilaterales); es decir, un45,5% de ojos lo padecieron. En el grupo dos, 3 ojos (9,1%) de dos pacientes lo padecieron en gradoleve. Existen diferencias estadísticamente significativasen los dos grupos (p=0,002). Si consideramosque un paciente sufre el síndrome sólo cuandotiene un grado moderado o grave, también existendiferencias significativas entre la proporción decasos con IFIS en el grupo uno con respecto al grupodos (p=0,0002).Conclusiones: El estudio demuestra la mayor efectividadestadísticamente significativa de la estrategiaaplicada en el grupo dos comparada a la aplicada al grupo uno(AU)

Objective: To compare the effectiveness of twostrategies to prevent the appearance of intraoperativefloppy iris syndrome (IFIS) in patients exposedto α-blockers.Methods: We compared retrospectively the presenceand severity of the appearance of IFIS in 29patients subjected to cataract surgery, establishingtwo groups of 12 patients (22 eyes) and 17 patients(33 eyes). The strategy applied to group one consistedof suspending the exposure to α-blockers for atleast one week prior to the intervention, the topicalapplication of 1% atropine three times a day for twodays before the intervention and the use of intracamerallidocaine. The strategy for group two consistedof suspending use of the drug for at least oneweek before the intervention and the intracameralapplication at the beginning of surgery of a solutionof physiological serum, adrenaline and lidocaine.Results: Six patients from group one showed noevidence of IFIS, 2 exhibited bilateral mildsymptoms, 2 bilateral moderate and 2 unilateral severe symptoms of IFIS. In total, 45.5% eyes sufferedfrom IFIS. In group two, only 3 eyes (9.1%)from 2 patients exhibited mild symptoms. Statisticalanalysis showed a significant difference betweenboth groups (p=0.002). If only those exhibitingmoderate and severe symptoms are taken intoaccount the result was highly statistically significant(p=0.0002).Conclusion: The study shows a greater statisticaleffectiveness of the strategy applied to group twocompared to the strategy applied to group one(AU)