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Copyright of Revista de Educación e Investigación en Emergencias is the property of Publicidad Permanyer SLU and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To analyze the prevalence of no-reflow and the 30-day mortality in a university center in a middle-income country. Method: We analyzed 2463 patients who underwent primary PCI from January 2006 to December 2021. The outcome measure was 30-day mortality. Results: Of a total of 2463 patients, no-reflow phenomenon was found in 413 (16.8%) patients, 30-day mortality was 16.7 vs. 4.29% (p < 0.001). Patients with no-reflow were older 60 (53-69.5) vs. 59 (51-66) (p = 0.001), with a higher delay in onset of symptom to emergency department arrival 270 vs. 247 min (p = 0.001). No-reflow patients also had had fewer previous myocardial infarction, 11.6 vs. 18.4 (p = 0.001) and a Killip class 1, 37 vs. 26% (p < 0.001). No-reflow patients were more likely to have an anterior myocardial infarction (55.4 vs. 47.8%; p = 0.005) and initial TIMI flow 0 (76 vs. 68%; p < 0.001). Conclusion: No-reflow occurred in 16.8% of STEMI patients undergoing primary PCI and was more likely with older age, delayed presentation, anterior myocardial infarction and Killip class > 1. No-reflow was associated with a higher mortality at 30-day follow-up. [ABSTRACT FROM AUTHOR]

Copyright of Revista Argentina de Cardiología is the property of Sociedad Argentina de Cardiologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: The debate on percutaneous coronary intervention (PCI) of the unprotected left main coronary artery (LMCA) has been constant over time. Objective: To investigate the clinical and procedural characteristics and cardiovascular outcomes of PCI of unprotected LMCA. Material and methods: Observational study which included patients with unprotected LMCA disease undergoing PCI; patients with cardiogenic shock prior to the procedure were excluded. We describe the clinical and angiographic characteristics, as well as the major adverse cardiac and cerebrovascular events (MACCE) according to the year of the procedure. Results: We included 73 patients, with a SYNTAX I score of 31.2 ± 9.1, mostly with ST-elevation acute coronary syndrome (35%). There was a higher frequency of triple vessel coronary disease (63%) and distal LMCA lesions (35%). The provisional stent technique was the most used for distal lesions (58%) and the 2-stent technique for bifurcation lesions (78%), supported by intravascular ultrasound (IVUS) in 38%. During follow-up, 19 presented MACCE (26%), out of which cardiac death occurred in 13%, non-cardiovascular death in 5%, non-fatal acute myocardial infarction in 1%, cerebrovascular event in 2%, and revascularization of the treated vessel in 4%. Conclusions: It was observed a similar frequency to the one appearing in other studies of cardiovascular events, mainly in patients with intermediate risk, which supports the increasing use of percutaneous intervention in this population. [ABSTRACT FROM AUTHOR]

Copyright of Gaceta Médica de México is the property of Publicidad Permanyer SLU and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Contrast induced nephropathy and nephroprotection are topics of great importance for many different medical areas, in diagnostic studies with iodinated radiocontrast agents, as therapeutic in percutaneous coronary intervention, and which has clear relationship with contrast type, quantity and other patient's factors with the development of nephropathy induced by these agents. This paper reviews the risk of especially iodinated contrast induced nephropathy and the different preventive available strategies. [ABSTRACT FROM AUTHOR]

Copyright of Revista Argentina de Cardiología is the property of Sociedad Argentina de Cardiologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Argentina de Cardiología is the property of Sociedad Argentina de Cardiologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: In the last two decades, advances in the percutaneous treatment of acute coronary syndrome have led to a reduction on its mortality, positioning percutaneous coronary intervention as the treatment of choice. The percutaneous coronary intervention is a challenging procedure due to its higher risk of related complications and the prevalence of multiple comorbidities. Objective: To evaluate the baseline profile and clinical outcomes over 6 months of follow-up post-percutaneous coronary intervention in patients older than 85 years-old submitted in the last three years to in-hospital coronary revascularization. Materials and method: This is an “all-comers” registry including patients ≥ 85 years-old treated with PCI in the last three years due to acute coronary syndrome. Results: We included 20 patients with a mean age of 90.3 years; of them, 55% female. The main comorbidities were: arterial hypertension (80%) and hyperlipidemia (58%). At the time of the intervention, 40% of the patients were diagnosed with ST-elevation coronary syndrome. Transradial percutaneous coronary intervention was performed on 70%, with successful target vessel revascularization in 90% of patients. There were 4 non-complicated vascular access-related bruises. Mortality was 0% over 6-months of follow-up. Conclusion: Percutaneous coronary intervention is a feasible and effective procedure with low rates of complications in patients over 85 years of age with diagnosis of acute coronary syndrome. [ABSTRACT FROM AUTHOR]

Copyright of Revista Argentina de Cardiología is the property of Sociedad Argentina de Cardiologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Enfermería en Cardiologia is the property of Asociacion Espanola de Enfermeria en Cardiologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: No-reflow (NR) phenomenon is one of the most feared complications after percutaneous coronary intervention (PCI) in the treatment of ST-segment elevation myocardial infarction (STEMI) due to its high morbidity and mortality. Objective: To describe the predictive factors for NR phenomenon in a group of subjects with STEMI treated with PCI. Method: One hundred and three cases of STEMI who underwent PCI. The subjects were divided according to the presence of NR phenomenon. In a multivariate analysis: age, gender, comorbidities, weight, and other clinical and laboratory parameters were studied as predictors of NR phenomenon were studied. Results: In this study, logistic regression analysis identified as independent factors for the development of NR phenomenon: baseline TIMI flow ≤ 2 (OR: 6.03; 95% CI, 0.9 to 11.8; p = 0.04), ER KDIGO ≥ 3 (OR: 3.49; 95%CI, 1.2 to 2.6; p = 0.02) and glucose level ≥ 180 mg/dL (OR:2.61; 95% CI, 1.0 to 2.4; p = 0.04). Conclusions: NR phenomenon continues to be a challenge for short and long-term morbidity and mortality in STEMI. The identified factors can be used for the stratification of cases with STEMI and risk of NR phenomenon prior to PCI. [ABSTRACT FROM AUTHOR]

Copyright of Enfermería en Cardiologia is the property of Asociacion Espanola de Enfermeria en Cardiologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Enfermería en Cardiologia is the property of Asociacion Espanola de Enfermeria en Cardiologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Coronary artery bypass grafting is the standard of care for patients with obstructive left main (LM) coronary disease. In poor surgical candidates, high-risk percutaneous coronary artery intervention (PCI) is an alternative. Methods: We investigated a retrospective cohort of patients who underwent LM PCI from January 2010 to March 2014 (n = 89). Obstructive LM disease was defined as 50% angiographic obstruction of luminal flow, and the primary endpoint was inhospital mortality. Ventricular assist device (VAD) was defined as the use of either intra-aortic balloon pump (IABP) or Impella 2.5 devices before, during, or following PCI. Results: A total of 89 patients with LM PCI were divided into those with (n = 39) and without (n = 50) VAD support. The former group was further divided into those with support from either Impella 2.5 (n = 28) or IABP (n = 11). Age, race, and gender did not differ between patients who received unassisted LM-PCI from those with VAD support (P = 0.142, 1.0, and 0.776, respectively). The angiographic stenosis of atherosclerotic lesions in LM, proximal left anterior descending artery, and other native/surgical coronary vessels was similar between the groups. The duration of hospitalization was significantly longer for patients with VAD support compared to those without (7.19 ± 6.89 vs. 2.78 ± 3.39, P < 0.001). The incidence of cardiogenic shock and inhospital mortality was significantly higher in the VAD group (P = 0.009 and 0.001, respectively). Overall, inhospital mortality was 9% (8/89). The IABP and Impella 2.5 groups had mortality proportions of 46% (5/11) and 11% (3/28), respectively; P = 0.028. For all patients, inhospital mortality was higher for those with versus without cardiogenic shock (56% or 5/9 vs. 4% or 3/80; P < 0.001), and for those with versus without left ventricular systolic function <40% (17% vs. 2%;P < 0.025). Conclusion: In a selected group of patients with LM disease, unsupported PCI appears to be a feasible and safe procedure. In high-risk patients, the use of Impella 2.5 appears to be superior to IABP in LM PCI resulting in favorable short-term outcomes. [ABSTRACT FROM AUTHOR]

Introduction: Primary percutaneous coronary intervention (PPCI) represents a timely procedure that requires speedy revascularization. Moreover, PPCI in diffuse coronary lesions remains to be challenging even in the hands of experienced operators as the use of a long stent may increase the difficulty of the procedure in terms of stent delivery, deployment, and optimization. However, the practicability and clinical outcomes of deployment of a 60-mm-long stent in the setting of PPCI remain to be determined. Methods: The study is a retrospective observational analysis in a prospective cohort. The prospectively gathered data of consecutive patients from June 2016 to December 2019, who underwent PPCI with BioMime sirolimus-eluting stents 2.5-3.0/60 mm or 3.0-3.5/60 mm were analyzed at 1 year regarding the primary outcome of major adverse cardiovascular and cerebrovascular events (MACCE) and target lesion revascularization (TLR). Results: A total of 88 cases were included in the study; 23 cases underwent PPCI, whereas 65 underwent nonPPCI. The PPCI group had a mean age of 65.7 ± 10.9 years compared with 63.3 ± 9.6 years (P = 0.34) in the nonPPCI group. Eighty-three percentage of PPCI were males compared with 94% of their nonPPCI counterparts (P = 0.20). In addition, the prevalence of hypertension was more common in the PPCI group (87% vs. 63%, P = 0.03). There was no statistically significant difference between the two groups regarding other comorbidities. The most common culprit vessel was the left anterior descending artery (57%) in the PPCI group and the right coronary artery (58%) in the nonPPCI. The use of a stent with a diameter of 2.5-3.0 mm was more common in both groups (61% in PPCI vs. 66% in nonPPCI, P = 0.8). MACCE occurred in four patients during a year of follow-up. One occurred in the PPCI group (4%) compared with three in the nonPPCI group (5%) (P = 1.00). TLR was required in two cases, one in each group (4% vs. 2%, P = 0.46). Conclusion: The use of a 60-mm-long stent in the setting of PPCI has an excellent 12-month outcome in procedural success, MACCE, and TLR. Large randomized studies are required to confirm these results. [ABSTRACT FROM AUTHOR]

Copyright of Revista Argentina de Cardiología is the property of Sociedad Argentina de Cardiologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Latinoamericana de Hipertension is the property of Revista Latinoamericana de Hipertension and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To determine the initial management and in-hospital mortality of patients with acute coronary syndrome who attended referral hospitals in Paraguay. Method: Observational, multicenter study, in patients over 18 years with a confirmed diagnosis of acute coronary syndrome. Results: 780 patients were included from May 2015 to February 2016; the mean age was 64.1 ± 12.3 years, 64.1% male. The clinical presentation was acute coronary syndrome with ST elevation in 40.1% and without elevation in 59.9%. In patients with ST elevation there is a high percentage of late attendance, more than 12 h of evolution in 49.8%; those with less than 12 h of evolution underwent reperfusion in 52.2% of the cases, received fibrinolytics in 36.3% of the cases, and primary percutaneous coronary intervention 15.9%. In-hospital mortality for acute coronary syndrome was 10.3%, with ST-segment elevation was 12.8%, and without ST-segment elevation was 8.6%. Conclusions: The management of acute coronary syndrome in Paraguay needs a comprehensive approach, which promotes earlier care, and increases the implementation of reperfusion therapies in the health services network, in order to improve the therapeutic response rates and decrease hospital mortality. [ABSTRACT FROM AUTHOR]

Introduction: Cardiovascular diseases represent the leading causes of death in the world and in Cuba. Percutaneous coronary intervention with drug-eluting stents has improved the treatment and evolution of these patients. Objective: To describe the clinical and angiographic characteristics of patients treated with ihtDEStiny stents and to identify major cardiac adverse events during clinical follow-up. Method: An observational, analytical and prospective study was carried out at the Instituto de Cardiología y Cirugía Cardiovascular of Havana, from June 2019 to December 2020, including the first 50 consecutive patients treated in Cuba with abluminal-coated sirolimus-eluting stent. Results: The mean age was 61.5 years old, with a predominance of males (88%). The predominant cardiovascular risk factor was high blood pressure (37 patients [74%]), followed by diabetes mellitus (13 [26%]). Seventy-nine stenoses were treated with a predominance of type B2 (48.1%) and an average of 1.58 stents per patient were implanted, in 60% of cases directly. The left anterior descending was the most affected coronary artery, the immediate success of the procedure was 98.7% and few major cardiac adverse events were detected after a clinical followup at 6 and 12 months. Conclusions: The treated patients show profiles of age, gender and risk factors similar to those of the rest of patients with coronary artery disease. The sirolimus drug-eluting stents used in this study are safe and guarantee a period free from major cardiac adverse events. [ABSTRACT FROM AUTHOR]

Objective: To determine the clinical adverse events related to the use of femoral and radial artery access in patients who underwent interventional cardiology procedures in the Hospital Nacional Hipólito Unanue from 2015 to 2017. Materials and methods: A comparative, retrospective, observational and analytical study was conducted with a total of 151 medical records of patients who had clinical adverse events. Medical record review was used as data collection technique, and a data collection sheet designed by the researcher was used as instrument. The R software was used for the analysis. Results: Out of 151 cardiac catheterizations, 51.66 % were performed by a femoral artery access and 48.34 % by a radial artery access. The average age of the patients was 59.6 ± 11.3 years, out of which 39.73 % ranged between 60 and 70 years, and 73.50 % of the patients were males. The most frequent comorbidities were arterial hypertension Horiz Med (Lima) 2022; 22(1): e1719 and diabetes mellitus. Non-serious clinical adverse events occurred as a result of both vascular access procedures; however, their incidence was high. Fifty percent (50%) of the patients who underwent a femoral artery access procedure showed the following adverse events: hematoma (25.60 %), bleeding (9 %), ischemia (1.30 %), vagal response (1.30 %), pseudoaneurysm (1.30 %), a rare skin rash that looked like a burn (1.30 %) and pain (10.20 %). In contrast, 19.14 % of the patients who underwent a radial artery access procedure presented hematoma (8.21 %), bleeding (2.73 %), radial artery spasm (1.40 %) and pain (6.80 %). Conclusions: After determining the clinical adverse events, it was concluded that radial artery access is better than femoral artery access for interventional cardiology procedures. [ABSTRACT FROM AUTHOR]

BACKGROUND: Coronary heart disease in patients without comorbidities should always raise suspicion of additional conditions that favor these events since it is usually not dependent on atherosclerotic disease. CLINCAL CASE: A 56-year-old female patient presented to the emergency department for chest pain with elevation of biomarkers of myocardial injury. A coronary arteriography was performed identifying a coronary arterial fistula, which produced coronary steal and angina. Endovascular correction of the defect was achieved successfully with clinical improvement. CONCLUSIONS: Coronary fistulas are rare findings in coronary angiography procedures. Patients mainly present with angina or decompensated heart failure. Optimal early corrections improve outcomes. [ABSTRACT FROM AUTHOR]

Copyright of Enfermería en Cardiologia is the property of Asociacion Espanola de Enfermeria en Cardiologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Argentina de Cardiología is the property of Sociedad Argentina de Cardiologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Patients with chronic kidney disease are at high risk of developing cardiomyopathy, atherosclerosis and arteriosclerosis. Atherosclerosis is the main cause of ischemic heart disease in CKD patients in substitute therapy such as dialysis (hemodialysis or peritoneal dialysis) and transplantation. In the case of dialysis, cardiovascular diseases increase the risk of arrhythmias and sudden cardiac death. Objectives: To provide a number of perioperative considerations to be taken into account during hemodynamic management of the chronic kidney disease patient by the multidisciplinary team involved in patient care with chronic kidney disease. Clinical case: We present a 52-year-old male patient with the following cardiovascular risk factors: age, sedentary lifestyle, hypertension, DMT2, CKD 5D KDIGO stage, congestive heart failure, New York Heart Association (NYHA) 2 and history of percutaneous coronary intervention (PCI) due to acute coronary syndrome, 5 years ago, in renal transplant protocol. The patient was successfully subjected to emergency PCI and during the endovascular procedure, a medicated balloon was placed. A In.Pact falcon™ DCB 3 x 20 mm intra stent to the prior DA and direct resolute onyx ™ DES 3.0 x 38 mm stent to the proximal segment of the circumflex artery. Conclusions: In this clinical case, coronary intervention was carried out successfully. The patient's evolution was favorable due to follow-up by multidisciplinary team made up of nephrologists, hemodynamic specialist, cardiologists, intensive care doctors and anesthesiologists who participated in the Infarction Code group. [ABSTRACT FROM AUTHOR]

Copyright of Revista Argentina de Cardiología is the property of Sociedad Argentina de Cardiologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Very late stent thrombosis is a rare complication but with high morbidity and mortality. Predisposing factors include clinical, anatomical and procedure-related parameters. Many pathophysiological mechanisms are considered to be responsible for stent thrombosis. The treatment of this complication consists of attempting to restore blood flow as soon as possible. We present the case of an individual diagnosed with ST-segment elevation myocardial infarction after very late thrombosis of conventional bare metal stent (20 months). The patient was successfully treated by percutaneous coronary intervention with two sirolimus-eluting stents. [ABSTRACT FROM AUTHOR]

Copyright of Enfermería en Cardiologia is the property of Asociacion Espanola de Enfermeria en Cardiologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Enfermería en Cardiologia is the property of Asociacion Espanola de Enfermeria en Cardiologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Enfermería en Cardiologia is the property of Asociacion Espanola de Enfermeria en Cardiologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Coronavirus disease 19 (COVID-19) is the infection caused by the SARS-CoV-2 virus and it has become a global emergency. The disease has a hughe impact on cardiopaths. Under regular conditions, patients entering the emergency room with a ST-segment elevation myocardial infarction (STEMI) must be urgently treated with reperfusion strategy. However, due to the scarce knowledge about COVID-19, there have not being yet established the guidelines for management of patients with STEMI and COVID-19. In this review we expose the main conclusions of relevant articles published about STEMI management during this pandemic. We aim to provide a review to guide the decisions about the management of STEMI during the COVID-19 emergency. [ABSTRACT FROM AUTHOR]

Cardiovascular diseases are the main cause of morbidity and mortality worldwide, and in Cuba, they have increased in recent years. Their ischemic origin represents the most frequent isolated disease causing death in Cuban people. The percutaneous coronary intervention (PCI) -as part of their treatment- is among the most developed areas within current Cardiology. There is a growing role of inflammation in these diseases; therefore, the search for new inflammatory markers, that are related to this procedure, is crucial. The neutrophil-to-lymphocyte ratio has been associated with the occurrence of complications during the PCI and monitoring of these patients, thus, an update in this regard is proposed. The evidence shows a significant relationship between the increase of this ratio, with the appearance of peri-procedure myocardial infarction, as well as with the adverse results in the follow-up; in a way, that opens a new route of research in interventional cardiology. [ABSTRACT FROM AUTHOR]

In this paper we describe our coronary stent (INC-1) design and development, the way that we found the specific characteristics needed for our device including biophysics aspects, design, finite element testing, manufacturing and mechanic trials we submitted and animal models experiences. The stent platform was cobalt-chromium L605 (Co-Cr), with struts thickness of 80 µm, balloon expandable. We placed the coronary stent INC-1 on a rabbit and dog models so we can evaluate efficacy and security of the device in relationship to its biomechanical properties including navigation capacity, traceability, symmetric expansion and safety. As well as endothelial attachment, thrombogenicity and lack of involvement of secondary branches in these models. We succeeded in efficacy and safety of the device after fluoroscopy-guided implant proving excellent capacity of release system, traceability, fluoroscopic visualization, symmetric expansion and complete endothelial attach. Also, we obtained a good post-implant balloon withdrawal, functional integrity and no vascular complications. We observed adequate clinical evolution 3 weeks after the stent implantation. [ABSTRACT FROM AUTHOR]

Introducción: Debido a la reciente implementación del sistema de red para la atención de pacientes con infarto agudo de miocardio con elevación del ST (IAM CEST) en México, el objetivo de este estudio fue comparar la mortalidad de estos pacientes por eventos cardiovasculares, la mortalidad general, tiempos de atención y complicaciones agudas en el año previo a la implementación del sistema y en el año posterior a la misma en el Instituto Mexicano del Seguro Social del estado de Guanajuato. Método: Estudio ecológico que comparó las bases de datos para evaluar la mortalidad general, por eventos cardiovasculares y complicaciones de los pacientes con IAM CEST en el año pre (2016, n=142) y post (2017, n=123) implementación del "código infarto" de pacientes en la región del Bajío, que recibieron Intervención Coronaria Percutánea. Resultados: Se identificó una disminución significativa después de inicio del "código infarto" en el total de eventos mayores (27.4% vs. 11.3%; p = 0.001) y en la presencia de insuficiencia cardiaca (11.2% vs. 0.8%; p = 0.006); pero sin diferencia específica en la muerte no cardiaca, en la presentación de angina, arritmias no fatales, o necesidad de revascularización entre los grupos. Discusión o Conclusión: La implementación del "código infarto" en la región del Bajío, México, tiene efectos benéficos en los eventos mayores cardiovasculares y presentación de insuficiencia cardiaca. [ABSTRACT FROM AUTHOR]

Copyright of Revista Argentina de Cardiología is the property of Sociedad Argentina de Cardiologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Cardiovascular rehabilitation is beneficial in multiple clinical situations. In patients who are treated through percutaneous coronary intervention it is necessary to continue deepening its study. Objectives: To determine the effects of cardiovascular rehabilitation in patients with ST-segment elevation acute myocardial infarction who underwent percutaneous coronary intervention. Method: Quasi-experimental study in 30 patients with ST-segment elevation acute myocardial infarction after being treated with coronary angioplasty, and who were attended at the Department of Cardiovascular Rehabilitation of the Hospital Universitario Celestino Hernández Robau, in the period from September 2016 to March 2018. Clinical and epidemiological data were collected, and ergometric and echocardiographic variables were analyzed before and after 12 weeks of developing a cardiovascular rehabilitation program. Results: There was a positive effect on heart rate at rest (66±11 vs. 61±11 beats/minute; p=0.008), exercise time (8.3±2.5 vs. 10.2±2.0 minutes; p<0.0001) and maximum oxygen consumption (24.2±5.0 vs. 27.6±4.9 ml/kg/min; p<0.0001). There was improvement of the ejection fraction and reduction of the diameter of the left ventricle in diastole left ventricular end diastolic diameter, but without significant statistical difference. Conclusions: There was improvement in the ergometric and echocardiographic parameters after the cardiovascular rehabilitation program, which was more beneficial in patients with high blood pressure, smoking habit and percutaneous coronary intervention of two arteries. [ABSTRACT FROM AUTHOR]

The spontaneous dissection of a coronary artery during pregnancy is a rare cause of acute myocardial infarction, with a high risk of maternal death. It can be diagnosed through coronary angiography, although many cases are diagnosed during autopsy. There is presented the case of a 38-year-old white woman, smoker, multiparous, that at the fifth day postpartum presented midthoracic, oppressive and intense pain, and the electrocardiogram evidenced an extensive acute anterior myocardial infarction. The coronary angiography showed dissection of the left coronary artery including the left main, the left anterior descending and the circumflex artery. A primary angioplasty was performed and there was a hyperacute thrombosis of the implanted stent. The patient died on the fifth day in refractory cardiogenic shock. There are no standard treatment recommendations, the primary angioplasty is considered the treatment of choice. The multidisciplinary integration of cardiologist, obstetrician, cardiac surgeon and anesthesiologist is essential to decide the best treatment. [ABSTRACT FROM AUTHOR]

BACKGROUND: Age is an important prognostic factor in patients with acute myocardial infarction. OBJECTIVE: To establish the characteristics and prognosis of older adults treated with mechanical reperfusion treatment. MATERIAL AND METHOD: A retrospective analysis including patients in the program code myocardial reperfusion treatment was carried out from January 2016 to December 2017. RESULTS: There were included 1025 patients; 15.3% older than 75 years. The age range was of 33 to 92 years. The mortality rate was increasing exponentially with higher age (3.4% in patients . 54 years, 6.1% in the group of 55 to 64 years, 9.2% in the group of 65 to 75 years and 15.9% in . 75 years, p < 0.001). In patients older than 75 years, primary angioplasty was the preferred method of reperfusion (77.7%), without finding in this group of patients an increase in the ischemic or hemorrhagic cerebral vascular event. Patients older than 75 years who develop cardiogenic shock had a much higher mortality compared with the younger (17.6%, 28%, 33% vs 56%, respectively; p < 0.001). CONCLUSIONS: Despite the different treatments of reperfusion, mortality remains higher in older adults, mainly by multiple comorbidities and a higher rate of ventricular dysfunction. [ABSTRACT FROM AUTHOR]

The life expectancy of people has increased in the last years, as a result, the prevalence of octogenarians with the diagnosis of acute myocardial infarction with ST-segment elevation (STEMI) has augmented. The evidence about the treatment with primary percutaneous coronary intervention (PCI) in this group of patients is limited and its prescription is controversial. Many retrospective assays have studied primary PCI in octogenarians with STEMI, and conclude that successful primary PCI can result in a reduction of early and long-term mortality. Taking into account the current evidence, the decision to perform primary PCI in the elderly should not be based on chronological age alone, but rather on each patient's benefit and eligibility for revascularization, we should consider the possible complications during and after the procedure. This article reports a clinical case of a female patient of 93 years old, that presented with acute myocardial infarction with ST-segment elevation, in which primary percutaneous intervention was performed successfully. [ABSTRACT FROM AUTHOR]

Introduction: Non-ST segment elevation acute coronary syndrome (NSTE-ACS) is responsible for 2 to 2.5 million deaths worldwide. The percutaneous coronary intervention is related to better evolution in patients of moderate and high risk; however, there are still doubts about the optimal time to carry out the procedure. Objectives: To identify the optimal time for the coronary angiography and percuta neous coronary intervention in patients with NSTE-ACS of moderate-high risk. Method: An observational, longitudinal and prospective study was conducted with 74 patients who were admitted with a diagnosis of NSTE-ACS at the «Instituto de Cardiología y Cirugía Cardiovascular», from January 1, 2011 to December 31, 2013. Results: A total of 74 patients were analyzed, with a mean age of 69.7±9.56 and a predominance of males (55.4%). There were no discrepancies between the risk factors in each group (p>0.05). The TIMI average was 4.8. Most of patients presented two-vessel disease. The infarct-related artery was mostly the left anterior descending artery. Major events occurred in 8 patients (10.8%), the largest number was observed in the late intervention group. The most frequent minor event was angina, (7 patients), most frequently in the late intervention group. The group with the lowest probability of survival was that of late treatment. Conclusions: The patients in the intermediate intervention group (between 12 and 24 hours, group B) showed the greatest benefits of the coronary angiography and reperfusion strategy. [ABSTRACT FROM AUTHOR]

Resumen En los países iberoamericanos y caribeños las cardiopatías, y en especial las cardiopatías isquémicas, constituyen la causa principal de muerte tanto en varones como en mujeres. En muchos de estos países los esfuerzos sobre salud pública y comunitaria tratan de definir las estrategias de cuidados que sean efectivas desde los puntos de vista clínico y de costes, promuevan la prevención primaria y secundaria, y redunden en la mejora de los resultados de los pacientes. El enfoque óptimo para el tratamiento de episodios agudos tales como el infarto de miocardio con elevación del segmento ST (IAMCEST) es una cuestión controvertida; sin embargo, el papel de la valoración de la carga isquémica residual en los pacientes de IAMCEST tras una intervención coronaria percutánea primaria se encuentra en expansión. Aunque los ensayos clínicos aleatorizados han establecido el valor de la revascularización guiada por la reserva de flujo fraccional escalonada, el uso de técnicas de imagen funcionales no invasivas puede jugar un papel similar a mucho menor coste. Para los pacientes iberoamericanos y caribeños, podrían aplicarse las técnicas disponibles de imágenes de estrés para definir la isquemia residual en la arteria no infartada y orientar la revascularización en un procedimiento escalonado tras una intervención coronaria percutánea primaria. El uso de imagen cardíaca nuclear, respaldado por su disponibilidad relativamente amplia, coste moderado y capacidades cuantitativas sólidas, puede servir de guía a una atención efectiva y reducir los episodios cardíacos subsiguientes en pacientes con cardiopatía coronaria. Esta técnica no invasiva puede evitar las cuestiones de seguridad potenciales de los procedimientos invasivos prolongados y repetidos, y servir de referencia para las pruebas subsiguientes de estrés tras el episodio de IAMCEST inicial. Este documento de consenso fue diseñado por la reunión del panel de expertos de la International Atomic Energy Agency y destaca la evidencia disponible centrada en la utilidad de la imagen de perfusión miocárdica de estrés en pacientes post-IAMCEST. El documento podría servir como guía para el uso prudente y adecuado de la imagen nuclear orientada a la gestión terapéutica, a fin de evitar los procedimientos invasivos innecesarios en los países iberoamericanos y caribeños, en los que los recursos podrían ser escasos. Across Latin American and Caribbean countries, cardiovascular disease and especially ischemic heart disease is currently the main cause of death both in men and in women. For most Latin American and Caribbean countries, public and community health efforts aim to define care strategies which are both clinically and cost effective and promote primary and secondary prevention, resulting in improved patient outcomes. The optimal approach to deal with acute events such as ST-elevation myocardial infarction (STEMI) is a matter of controversy; however, there is an expanding role for assessing residual ischemic burden in STEMI patients following primary percutaneous coronary intervention. Although randomized clinical trials have established the value of staged fractional flow reserve-guided revascularization, the use of noninvasive functional imaging modalities may play a similar role at a much lower cost. For LAC, available stress imaging techniques could be applied to define residual ischemia in the non-infarct related artery and to target revascularization in a staged procedure after primary percutaneous coronary intervention The use of nuclear cardiac imaging, supported by its relatively wide availability, moderate cost, and robust quantitative capabilities, may serve to guide effective care and to reduce subsequent cardiac events in patients with coronary artery disease. This noninvasive approach may avert potential safety issues with repeat and lengthy invasive procedures, and serve as a baseline for subsequent follow-up stress testing following the index STEMI event. This consensus document was devised from an expert panel meeting of the International Atomic Energy Agency, highlighting available evidence with a focus on the utility of stress myocardial perfusion imaging in post-STEMI patients. The document could serve as guidance to the prudent and appropriate use of nuclear imaging for targeting therapeutic management and avoiding unnecessary invasive procedures within Latin American and Caribbean countries, where resources could be scarce. [ABSTRACT FROM AUTHOR]

The very late thrombosis of a conventional stent is an uncommon event, although its consequences can be catastrophic for the patient, being associated with an increase in the long-term mortality rate. Here is exposed the case of a 60-year-old man who presented an acute inferior myocardial infarction due to definitive thrombosis of the conventional stent, after 24 months of implantation. [ABSTRACT FROM AUTHOR]

Copyright of Enfermería en Cardiologia is the property of Asociacion Espanola de Enfermeria en Cardiologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Enfermería en Cardiologia is the property of Asociacion Espanola de Enfermeria en Cardiologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Acta Medica Colombiana is the property of Acta Medica Colombiana and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: In patients with acute coronary syndrome the first 24 hours of evolution, the state of inflammation and platelet activation are higher, especially if the mechanical operations are added to restore the flow, including stenting, which favors the phenomenon of "no-reflow". Objective: To determine whether the deferral of the application of the stent in patients with acute myocardial infarction event rate decreases no-reflow. Methods: Observational, descriptive, longitudinal, and comparative ambispective study in the Hospital Central Militar (Mexico) 12 hours of evolution. Two groups were formed: the first received immediate treatment and the second was deferred, on average, 64 hours. Results: 26 patients, 23 males (88%) and 3 women (12%) were studied. A 11 underwent angioplasty and stenting plus deferred ball over (42%) (group 1) and 15 were treated with angioplasty and stenting immediately (58%) (group 2). In the acute event group 1 smaller proportion of noreflow although not statistically significant for the size of the sample was observed. In either group, there were deaths. Conclusions: The deferral of the implementation of the stent in patients with acute myocardial infarction resulted in lower event rate of no-reflow. To confirm the benefits and safety of this procedure will be necessary to study a larger sample of patients. [ABSTRACT FROM AUTHOR]

Copyright of Médicas UIS is the property of Universidad Industrial de Santander and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: Evaluate the 5 years cumulative incidence of MACE in patients with LM.C.AD associated to multivessel coronary artery disease treated with PCI and stent implantation. Material and methods: We evaluated: 1) Mortality from cardiovascular causes, 2) Mortality from non-cardiovascular causes, 3) Myocardial infarction, 4) Target vessel revascularization and 5) Stroke, in patients with Left Main Coronary Artery Disease (diagnosed from coronariography or intravascular ultrasound) treated with PCI and stent implantation (January 2009 to November 2014) to the last clinical follow up available at the time of study completion. Results: Population consisted in 42 patients, with a mean age of 70.16±9.94years (p =0.075), history of smoking (54.76%), hypertension (71.42%) and diabetes (54.76%). 21.42% of them had been previously treated with CABG and 30.95% with prior PCI. Syntax Score was 33.52±11.52. 6 deaths from cardiovascular causes (14.3%) and 2 non-cardiovascular causes were registered, 3 cases of periprocedural MI and a single target vessel revascularization event and no stroke were recorded, with a cumulative incidence of MACE of 23.8% during hospitalization. Median follow-up was 91 days with a maximum of 4.7 years and accumulative incidence of MACE of 35.6%. [ABSTRACT FROM AUTHOR]

The Syntax score has been established as a tool to determine the complexity of coronary artery disease and as a guide for decision-making among coronary artery bypass surgery and percutaneous coronary intervention. The purpose of this review is to systematically examine what the Syntax score is, and how the surgeon should integrate the information in the selection and treatment of patients. We reviewed the results of the SYNTAX Trial, the clinical practice guidelines, as well as the benefits and limitations of the score. Finally we discuss the future directions of the Syntax score. [ABSTRACT FROM AUTHOR]