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array:19 [ "pii" => "S0025775306718838" "issn" => "00257753" "doi" => "10.1157/13084869" "estado" => "S300" "fechaPublicacion" => "2006-02-18" "documento" => "article" "subdocumento" => "fla" "cita" => "Med Clin. 2006;126:206-10" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 2890 "formatos" => array:3 [ "EPUB" => 7 "HTML" => 2456 "PDF" => 427 ] ] "itemSiguiente" => array:15 [ "pii" => "S002577530671884X" "issn" => "00257753" "doi" => "10.1157/13084870" "estado" => "S300" "fechaPublicacion" => "2006-02-18" "documento" => "article" "subdocumento" => "fla" "cita" => "Med Clin. 2006;126:211-3" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 17913 "formatos" => array:3 [ "EPUB" => 7 "HTML" => 1286 "PDF" => 16620 ] ] "es" => array:10 [ "idiomaDefecto" => true "titulo" => "Revaluación del método estándar (criterios de Light) para identificar exudados pleurales" "tienePdf" => "es" "tieneTextoCompleto" => 0 "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "211" "paginaFinal" => "213" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Reappraisal of the standard method (Light's criteria) for identifying pleural exudates" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "José M. Porcel, José M. Peña, Carmina Vicente de Vera, Aureli Esquerda" "autores" => array:4 [ 0 => array:2 [ "nombre" => "José M." "apellidos" => "Porcel" ] 1 => array:2 [ "nombre" => "José M." "apellidos" => "Peña" ] 2 => array:2 [ "nombre" => "Carmina" "apellidos" => "Vicente de Vera" ] 3 => array:2 [ "nombre" => "Aureli" "apellidos" => "Esquerda" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S002577530671884X?idApp=UINPBA00004N" "url" => "/00257753/0000012600000006/v0_201607111356/S002577530671884X/v0_201607111358/es/main.assets" ] "itemAnterior" => array:14 [ "pii" => "13084891" "issn" => "00257753" "estado" => "S300" "fechaPublicacion" => "2006-02-18" "documento" => "article" "subdocumento" => "fla" "cita" => "Med Clin. 2006;126:240" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 5881 "formatos" => array:3 [ "EPUB" => 7 "HTML" => 5502 "PDF" => 372 ] ] "es" => array:10 [ "idiomaDefecto" => true "titulo" => "Shock anafiláctico por hidatidosis hepática fisurada." "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "240" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Anaphylaxy caused by fissured hepatic hydatidosis" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig1" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "copyright" => "Elsevier España" "figura" => array:1 [ 0 => array:4 [ "imagen" => "2v126n06-13084891fig01.jpg" "Alto" => 951 "Ancho" => 1386 "Tamanyo" => 62293 ] ] "descripcion" => array:1 [ "es" => "Quiste hidatídico hepático un mes antes." ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "José Ignacio Barranco Domínguez, Antonio Martínez Germán, Rafael Cerdán Pascual, José María Miguelena Bobadilla" "autores" => array:4 [ 0 => array:2 [ "nombre" => "José Ignacio" "apellidos" => "Barranco Domínguez" ] 1 => array:2 [ "nombre" => "Antonio" "apellidos" => "Martínez Germán" ] 2 => array:2 [ "nombre" => "Rafael" "apellidos" => "Cerdán Pascual" ] 3 => array:2 [ "nombre" => "José María" "apellidos" => "Miguelena Bobadilla" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/13084891?idApp=UINPBA00004N" "url" => "/00257753/0000012600000006/v0_201607111356/13084891/v0_201607111358/es/main.assets" ] "es" => array:12 [ "idiomaDefecto" => true "titulo" => "Uso de bloqueadores beta en pacientes ancianos con insuficiencia cardíaca" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "206" "paginaFinal" => "210" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Agustín Urrutia, Josep Lupón, Salvador Altimir, Beatriz González, Joan Herreros, Crisanto Díez, Ramón Coll, Vicente Valle, Celestino Rey-Joly" "autores" => array:9 [ 0 => array:4 [ "nombre" => "Agustín" "apellidos" => "Urrutia" "email" => array:1 [ 0 => "aurrutia@ns.hugtip.scs.es" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor1" ] ] ] 1 => array:3 [ "nombre" => "Josep" "apellidos" => "Lupón" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] ] ] 2 => array:3 [ "nombre" => "Salvador" "apellidos" => "Altimir" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] ] ] 3 => array:3 [ "nombre" => "Beatriz" "apellidos" => "González" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] ] ] 4 => array:3 [ "nombre" => "Joan" "apellidos" => "Herreros" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] ] ] 5 => array:3 [ "nombre" => "Crisanto" "apellidos" => "Díez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] ] ] 6 => array:3 [ "nombre" => "Ramón" "apellidos" => "Coll" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] ] ] 7 => array:3 [ "nombre" => "Vicente" "apellidos" => "Valle" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] ] ] 8 => array:3 [ "nombre" => "Celestino" "apellidos" => "Rey-Joly" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] ] ] ] "afiliaciones" => array:1 [ 0 => array:3 [ "entidad" => "Unidad de Insuficiencia Cardíaca. Hospital Universitari Germans Trias i Pujol. Universitat Autònoma de Barcelona. Badalona. Barcelona. España" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "<span class="elsevierStyleSup">*</span>" "correspondencia" => "Correspondencia: Dr. A. Urrutia. Servicio de Medicina Interna. Hospital Universitari Germans Trias i Pujol. Ctra. de Canyet, s/n. Badalona. Barcelona. España. aurrutia@ns.hugtip.scs.es" ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Use of betablockers in elderly patients with congestive heart failure" ] ] "pdfFichero" => "2v126n06a90151397pdf001.pdf" "tienePdf" => true "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec690901" "palabras" => array:3 [ 0 => "Bloqueadores beta" 1 => "Ancianos" 2 => "Insuficiencia cardíaca" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec690902" "palabras" => array:3 [ 0 => "Betablockers" 1 => "Elderly patients" 2 => "Congestive heart failure" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Fundamento y objetivo</span><br/><p class="elsevierStylePara">Diversos estudios han demostrado que los bloqueadores beta (BB) disminuyen la mortalidad en los pacientes afectados de insuficiencia cardíaca (IC), pero son pocos los estudios dirigidos específicamente a la población realmente anciana. Nuestro objetivo es analizar las características de los pacientes ancianos con IC tratados con BB y si este tratamiento se relaciona con una mejor evolución.</p><span class="elsevierStyleSectionTitle">Pacientes y método</span><br/><p class="elsevierStylePara">Hemos estudiado las características clínicas y funcionales de los pacientes de edad igual o superior a 75 años atendidos en la Unidad de Insuficiencia Cardíaca de nuestro hospital, hemos analizado las características diferenciales de los que tomaban BB frente a los que no los tomaban y evaluado la mortalidad de los 2 grupos de pacientes.</p><span class="elsevierStyleSectionTitle">Resultados</span><br/><p class="elsevierStylePara">Un total de 47 de 107 pacientes recibió tratamiento con BB. Sólo en 3 pacientes fue preciso retirar la medicación por intolerancia o efectos secundarios. El grupo que no recibió tratamiento era algo mayor, estaba en peor clase de la New York Heart Association (NYHA), tenía mayor prevalencia de enfermedad pulmonar obstructiva crónica (EPOC), aunque las diferencias no eran estadísticamente significativas, y mostraba peor situación funcional. Los que recibieron BB tenían mayor frecuencia de cardiopatía isquémica. Las razones por las que algunos pacientes no los recibieron fueron estenosis aórtica importante (n=2), insuficiencia mitral grave (n=9), asma-EPOC (n=28), vasculopatía periférica (n=16) y fragilidad (n=9). La cuarta parte de los pacientes tratados con BB alcanzó la dosis plena o el escalón de dosificación previo. La mortalidad tanto al año (un 5,7 frente al 27,6%) como a los 2 años (el 20,68 frente al 60%) fue significativamente inferior (p=0,01 y p=0,002, respectivamente) en los que pudieron recibir BB que en los no tratados.</p><span class="elsevierStyleSectionTitle">Conclusiones</span><br/><p class="elsevierStylePara">En nuestra experiencia, aproximadamente el 44% de los pacientes ancianos con IC de diversa etiología son tratados con BB, con buena tolerancia. Es más probable que estos fármacos se administren a los ancianos con cardiopatía isquémica, en mejor clase de la NYHA, con menor deterioro funcional y que no presenten EPOC grave. Los ancianos con IC que pueden recibir tratamiento con BB tienen menor mortalidad al año y a los 2 años.</p>" ] "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Background and objective</span><br/><p class="elsevierStylePara">Few studies of betablockers (BB) have been performed specifically in older patients with congestive heart failure (CHF). We evaluated the characteristics of elderly patients with CHF treated with BB. Moreover, we assessed whether BB are associated with a better outcome in them.</p><span class="elsevierStyleSectionTitle">Patients and method</span><br/><p class="elsevierStylePara">We evaluated clinical and functional characteristics of patients aged ≥ 75 years with CHF treated with or without BB, with special interest being paid in the mortality.</p><span class="elsevierStyleSectionTitle">Results</span><br/><p class="elsevierStylePara">47 out of 107 patients were treated with BB. Only in 3 it was necessary to withdraw BB. Patients treated with no BB were older, with a higher New York Heart Association (NYHA) class, more prevalent chronic obstructive pulmonary disease (COPD) and in poorer functional situation. In patients treated with BB, ischemic heart disease was more prevalent. Reasons for «no treatment with BB» were severe aortic stenosis (n=2), severe mitral regurgitation (n=9), asthma-COPD (n=28), arterial disease (n=16) and fragility (n=9). 25% of the patients on BB reached the target dose. One-year mortality (5.7% vs 27.6%) and 2-year mortality (20.68% vs 60%) were both significantly lower (p=0.01 and p=0.002, respectively) in patients on BB.</p><span class="elsevierStyleSectionTitle">Conclusions</span><br/><p class="elsevierStylePara">44% of our elderly patients with CHF received BB with good tolerance. Patients treated with BB were younger, with more ischemic heart disease, better NYHA class, less functional deterioration and without COPD. One-year and two-year mortality in patients who can receive BB were lower.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliograf¿a" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:30 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "The effect of carvedilol on morbidity and mortality in patients with chronic heart failure. N Engl J Med. 1996; 334:1349-55." "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "The effect of carvedilol on morbidity and mortality in patients with chronic heart failure." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:7 [ 0 => "Packer M" 1 => "Bristow MR" 2 => "Cohn JN" 3 => "Colucci WS" 4 => "Fowler MB" 5 => "Gilbert EM" 6 => "et-al." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1056/NEJM199605233342101" "Revista" => array:6 [ "tituloSerie" => "N Engl J Med. 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" "fecha" => "1999" "volumen" => "353" "paginaInicial" => "9" "paginaFinal" => "12" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10023943" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib3" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Effect of metoprolol CR/XL in chronic heart failure: Metoprolol CR/XL Randomised Intervention Trial in Congestive Heart Failure (MERIT-HF). Lancet. 1999; 353:2001-7." "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Effect of metoprolol CR/XL in chronic heart failure: Metoprolol CR/XL Randomised Intervention Trial in Congestive Heart Failure (MERIT-HF)." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "The MERIT-HF investigators." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Lancet. " "fecha" => "1999" "volumen" => "353" "paginaInicial" => "2001" "paginaFinal" => "2007" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10376614" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib4" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Beta-blockers in congestive heart failure. A bayesian metaanálisis. Ann Intern Med. 2001; 134:50-60." "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Beta-blockers in congestive heart failure. A bayesian metaanálisis." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "Brophy JM" 1 => "Joseph L" 2 => "Rouleau JL." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Ann Intern Med. " "fecha" => "2001" "volumen" => "134" "paginaInicial" => "50" "paginaFinal" => "60" ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib5" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "The effects of beta-blockers on morbidity and mortality in a populationbased cohort of 11,942 elderly patients with heart failure. Am J Med. 2002; 113:650-6." "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "The effects of beta-blockers on morbidity and mortality in a populationbased cohort of 11,942 elderly patients with heart failure." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "Sin DD" 1 => "McAlister FA." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Am J Med. " "fecha" => "2002" "volumen" => "113" "paginaInicial" => "650" "paginaFinal" => "656" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12505115" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib6" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Obstacles to the initiation of betablockers for heart failure in a specialised clinic within a district general hospital. Heart. 2003; 89:442-4." "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Obstacles to the initiation of betablockers for heart failure in a specialised clinic within a district general hospital." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "Mahmoudi M" 1 => "MacDonagh S" 2 => "Poole-Wilson PA" 3 => "Dubrey SW." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Heart. " "fecha" => "2003" "volumen" => "89" "paginaInicial" => "442" "paginaFinal" => "444" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12639877" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib7" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "The fear of beta-blocker therapy in heart failure. JAMA. 2004; 164:1370-1." "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "The fear of beta-blocker therapy in heart failure." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "Chaterjee K." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "JAMA. " "fecha" => "2004" "volumen" => "164" "paginaInicial" => "1370" "paginaFinal" => "1371" ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib8" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Características clínicas, tratamiento y morbimortalidad a corto plazo de pacientes con insuficiencia cardíaca controlados en consultas específicas de insuficiencia cardíaca. Resultados del registro BADAPIC. Rev Esp Cardiol. 2004; 57:1159-69." "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Características clínicas, tratamiento y morbimortalidad a corto plazo de pacientes con insuficiencia cardíaca controlados en consultas específicas de insuficiencia cardíaca. Resultados del registro BADAPIC." "idioma" => "es" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "Anguita Sánchez M y los investigadores del registro BADAPIC." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Rev Esp Cardiol. " "fecha" => "2004" "volumen" => "57" "paginaInicial" => "1159" "paginaFinal" => "1169" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15617639" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib9" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "The EuroHeart Failure Survey programme – a survey on the quality of care among patients with heart failure in Europe Part 2: treatment. Eur Heart J. 2003; 24:464-74." "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "The EuroHeart Failure Survey programme – a survey on the quality of care among patients with heart failure in Europe Part 2: treatment." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:8 [ 0 => "The Study Group of Diagnosis of the Working Group on Heart Failure of the European Society of Cardiology" 1 => "Komajda M" 2 => "Follath F" 3 => "Swedberg K" 4 => "Cleland J" 5 => "Aguilar JC" 6 => "Cohen-Solal A" 7 => "et-al." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Eur Heart J. " "fecha" => "2003" "volumen" => "24" "paginaInicial" => "464" "paginaFinal" => "474" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12633547" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib10" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Age is not a significant risk factor for failed trial of betablocker therapy in older patients with chronic heart failure. Age and Ageing. 2004; 33:467-72." 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