Creencias respecto al ejercicio físico y cambios psicológicos tras sufrir un Síndrome Coronario Agudo

Currently, there are still some questions about the psychological state after an Acute Coronary Syndrome (ACS). The first goal, based on a pilot study composed of men and women, were evaluated the changes in beliefs regarding the usefulness of exercise as a health tool. The second one, from a new study formed by women, consisted on comparing the changes in psychological variables and their adjustments to the disease as well as observe differences, after going through a cardiac rehabilitation program that includes physical exercise. We evaluated 37 patients of both sexes in study 1 (m = 59.38 years of age (dt = 9.80)) and 28 women in study 2 (m = 62.68 years of age (dt = 10.6)) who presented an ACS and to whom we had performed a diagnostic catheterization with therapeutic intent within the first 3 days. The results of the pilot study indicate a change in beliefs regarding the exercise after passing through the program. Study 2, indicates that at 3 months intrasubject changes are shown in anger expression, adjustment to the disease, health care, professional environment, distress and mental healthActualmente existen interrogantes acerca del estado psicológico tras un Síndrome Coronario Agudo (SCA). El primer objetivo, a partir de un estudio piloto compuesto por hombres y mujeres, fue evaluar los cambios en las creencias respecto a la utilidad del ejercicio como herramienta de salud psicológica y física. El segundo, a partir de un segundo estudio formado por mujeres, consistió en comparar los cambios en variables psicológicas y su ajuste a la enfermedad así como observar diferencias, tras su paso por un programa de rehabilitación cardiaca que incluye ejercicio físico. Se evaluaron 37 pacientes de ambos sexos en el estudio 1 (m = 59.38 años de edad (dt = 9.80)) y 28 mujeres en el estudio 2 (m = 62.68 años de edad (dt = 10.6)) que presentaron un SCA y a las que se les había realizado un cateterismo diagnóstico con intención terapéutica dentro de los 3 primeros días. Los resultados del estudio piloto indican un cambio en las creencias respecto al ejercicio tras su paso por el programa. Además, el estudio 2, señala que a los 3 meses se muestran cambios intrasujetos en expresión de ira, ajuste a la enfermedad, cuidado de la salud, ámbito profesional, distrés y salud menta

Comparison of 1-year outcome in patients with severe aorta stenosis treated conservatively or by aortic valve replacement or by percutaneous transcatheter aortic valve implantation (data from a multicenter Spanish registry)

The factors that influence decision making in severe aortic stenosis (AS) are unknown. Our aim was to assess, in patients with severe AS, the determinants of management and prognosis in a multicenter registry that enrolled all consecutive adults with severe AS during a 1-month period. One-year follow-up was obtained in all patients and included vital status and aortic valve intervention (aortic valve replacement [AVR] and transcatheter aortic valve implantation [TAVI]). A total of 726 patients were included, mean age was 77.3 ± 10.6 years, and 377 were women (51.8%). The most common management was conservative therapy in 468 (64.5%) followed by AVR in 199 (27.4%) and TAVI in 59 (8.1%). The strongest association with aortic valve intervention was patient management in a tertiary hospital with cardiac surgery (odds ratio 2.7, 95% confidence interval 1.8 to 4.1, p <0.001). The 2 main reasons to choose conservative management were the absence of significant symptoms (136% to 29.1%) and the presence of co-morbidity (128% to 27.4%). During 1-year follow-up, 132 patients died (18.2%). The main causes of death were heart failure (60% to 45.5%) and noncardiac diseases (46% to 34.9%). One-year survival for patients treated conservatively, with TAVI, and with AVR was 76.3%, 94.9%, and 92.5%, respectively, p <0.001. One-year survival of patients treated conservatively in the absence of significant symptoms was 97.1%. In conclusion, most patients with severe AS are treated conservatively. The outcome in asymptomatic patients managed conservatively was acceptable. Management in tertiary hospitals is associated with valve intervention. One-year survival was similar with both interventional strategies