Incidencia y pronóstico del bloqueo interauricular en el infarto agudo de miocardio con elevación del segmento ST

Varios estudios recientes han demostrado la influencia del bloqueo interauricular (BIA) en diferentes escenarios, como en el desarrollo de futuras taquiarritmias supraventriculares o de fibrilación auricular, o en la aparición de ictus y demencia. Sin embargo, de momento es desconocida la posible influencia del BIA en el pronóstico después de sufrir un infarto agudo de miocardio con elevación del segmento ST (IAMCEST). Nuestro objetivo es estudiar la presencia y características del BIA en pacientes que desarrollan un IAMCEST, y conocer el impacto pronóstico del BIA después de un IAMCEST de acuerdo con la mortalidad a largo plazo y el desarrollo de fibrilación auricular e ictus..

Seasonality in Mortality in a Cardiology Department: A Five-Year Analysis in 500 Patients

Background: Previous studies have indicated that cardiovascular mortality follows a seasonal trend. The aim of this work was to determine the evolution of mortality throughout the year in a cardiology department. Methods: All admissions and deaths occurring in our Cardiology Department over a 5-year period (2013–2017) were recorded retrospectively. Results: From a total of 17,829 hospital admissions, 500 patients died (2.8%, 0.3 patients/day). The mean age of deceased patients was 74.2 ± 13.1 years, and 186 (37.2%) were women. Mortality ranged from 0.17 deaths/day in August to 0.40 deaths/day in February (p = 0.03), and from 0.20 deaths/day in summer to 0.36 deaths/day in winter (p = 0.001). There was also a trend towards a variation in hospitalizations, with a peak in January (10.5 admissions/day) and the lowest figure in August (7.0 admissions/day), p = 0.047. We found no significant seasonal trend regarding mortality rate with respect to the number of hospital admissions (p = 0.89). The most common cause of death was refractory heart failure (267 patients [65.8%]). A noncardiac cause of death was observed in 134 patients (26.8%). Conclusions: In a cardiology department, there are twice as many deaths in winter as in summer. Hospitalizations also tend to be more frequent in winter than in summer.Sin financiación1.791 JCR (2019) Q3, 93/138 Cardiac & Cardiovascular Systems0.559 SJR (2019) Q2, 166/362 Cardiology and Cardiovascular Medicine, 125/263 Pharmacology (medical)No data IDR 2019UE

Clinical Profile and Ventricular Arrhythmias after Sacubitril/Valsartan Initiation

Sin financiación1.791 JCR (2019) Q3, 93/138 Cardiac & Cardiovascular Systems0.559 SJR (2019) Q2, 166/362 Cardiology and Cardiovascular Medicine, 125/263 Pharmacology (medical)No data IDR 2019UE

Preparticipation screening in pediatric athletes. Should we be concerned about the PR interval?

Sin financiación4.753 JCR (2020) Q2, 45/142 Cardiac & Cardiovascular Systems0.455 SJR (2020) Q3, 202/349 Cardiology and Cardiovascular MedicineNo data IDR 2020UE

Cribado preparticipativo de deportistas pediátricos. ¿Debería preocupar el intervalo PR?

Sin financiaciónNo data JCR 20200.995 SJR (2020) Q1, 558/2447 Medicine (miscellaneous)No data IDR 2019UE

An overview of end-of-life issues in a cardiology department. Is the mode of death worse in the cardiac intensive care unit?

Sin financiación2.491 JCR (2019) Q2, 66/138 Cardiac & Cardiovascular Systems; Q3, 30/51 Geriatrics & Gerontology0.696 SJR (2019) Q2, 130/362 Cardiology and Cardiovascular Medicine, 50/109 Geriatrics and GerontologyNo data IDR 2019UE

End-of-life care in a cardiology department: Have we improved?

nd-of-life care is not usually a priority in cardiology departments. We sought to evaluate the changes in end-of-life care after the introduction of a do-not-resuscitate (DNR) order protocol. Retrospective analysis of all deaths in a cardiology department in two periods, before and after the introduction of the protocol. Comparison of demographic characteristics, use of DNR orders, and end-of-life care issues between both periods, according to the presence in the second period of the new DNR sheet (Group A), a conventional DNR order (Group B) or the absence of any DNR order (Group C). The number of deaths was similar in both periods (n = 198 vs. n = 197). The rate of patients dying with a DNR order increased significantly (57.1% vs. 68.5%; P = 0.02). Only 4% of patients in both periods were aware of the decision taken about cardiopulmonary resuscitation. Patients in Group A received the DNR order one day earlier, and 24.5% received it within the first 24 h of admission (vs. 2.6% in the first period; P < 0.001). All patients in Group A with an implantable cardioverter defibrillator (ICD) had shock therapies deactivated (vs. 25.0% in the first period; P = 0.02). The introduction of a DNR order protocol may improve end-of-life care in cardiac patients by increasing the use and shortening the time of registration of DNR orders. It may also contribute to increase ICD deactivation in patients with these orders in place. However, the introduction of the sheet in late stages of the disease failed to improve patient participation.Sin financiación1.806 JCR (2016) Q3, 86/126 Cardiac and Cardiovascular Systems; Q4, 36/49 Geriatrics and GerontologyUE

Circadian Rhythm of Deaths in a Cardiology Department: A Five-Year Analysis

Background: Previous studies have described a circadian pattern of death from cardiovascular causes with a morning peak. Our aim is to describe the daytime oscillations in mortality in hospitalized patients with cardiovascular diseases. Methods: Our retrospective registry including all patients who died in the Cardiology Department, including the cardiac intensive care unit, Madrid, Spain. Results: From a total of 500 patients, time of death was registered in 373 (74.6%), which are the focus of our study; 354 (70.8%) died in the cardiac intensive care unit and 146 (29.2%) in the conventional ward. Mean age was 74.2 ± 13.1 years, and 239 (64.1%) were male. Cardiovascular causes were the leading cause of death (308 patients; 82.6%). Mortality followed a circadian biphasic pattern with a peak at dawn (00.00-05.59 a.m.: 104 patients [27.9%]) and in the afternoon (12.00-17.59 p.m.: 135 patients [36.2%]), irrespective of the cause of death. The peak of mortality occurred in the afternoon (12.00-17.59 p.m.) in the case of cardiovascular mortality (119 deaths [38.6%]) and in the evening (18.00-23.59 p.m.) for non-cardiovascular deaths (21 deaths [32.3%], p = 0.03). This pattern was present regardless from the place of death (conventional ward or cardiac intensive care unit) and also throughout the four seasons. Conclusions: Mortality in hospitalized patients with cardiovascular diseases follows a circadian biphasic pattern.Sin financiación1.869 JCR (2020) Q4, 116/142 Cardiac & Cardiovascular Systems0.547 SJR (2020) Q3, 174/349 Cardiology and Cardiovascular MedicineNo data IDR 2020UE

Ticagrelor and Infection Risk in Patients with Coronary Artery Disease

Ticagrelor has a bactericidal effect in vitro, and clinical studies suggest a beneficial effect in infections. Our aim was to determine the incidence of infections in patients treated with 3 different P2Y12 receptor inhibitors. Methods: Retrospective registry in a cardiology department. Patients with coronary artery disease discharged on ticagrelor, prasugrel, or clopidogrel from March 2017 to June 2019 were included. The risk of infection was analyzed during the period of P2Y12 inhibitor treatment (12.4 ± 6.7 months). Results: A total of 250 patients were included (ticagrelor 91 [36.4%], prasugrel 89 [35.6%], clopidogrel 70 [28.0%]). Mean age was 61.0 ± 13.1 years, and 63 (25.2%) were women. The most common reason to use these drugs was ST-segment elevation acute myocardial infarction (STEMI) (152 patients - 60.8%). STEMI was the reason to use prasugrel in 84 patients (94.4%), ticagrelor in 44 (48.4%), and clopidogrel in 24 (34.3%), p < 0.001. An infection during follow-up was seen in 87 patients (34.8%), 23 treated with ticagrelor (25.3%), 30 with prasugrel (33.7%) and 34 with clopidogrel (48.6%), p = 0.009. Ticagrelor was independently associated with a lower likelihood of infection (Hazard Ratio [HR] 0.52, 95% confidence interval [CI] 0.28-0.95; p = 0.035) compared to prasugrel (HR 0.96, 95% CI 0.54-1.73; p = 0.909) and clopidogrel (HR = 1). Conclusions: In patients admitted with coronary artery disease patients treated with ticagrelor had a lower frequency of infections during follow-up than those treated with other P2Y12 inhibitors. Further studies are necessary to clarify the bactericidal effect of ticagrelor in this context.Sin financiación2.342 JCR (2021) Q3, 103/143 Cardiac & Cardiovascular Systems0.524 SJR (2021) Q2, 127/265 Pharmacology (medical)No data IDR 2020UE