covid
Buscar en
Revista Colombiana de Cardiología
Toda la web
Inicio Revista Colombiana de Cardiología Cumplimiento de las recomendaciones de prevención secundaria de enfermedad coro...
Información de la revista
Vol. 20. Núm. 2.
Páginas 70-76 (marzo - abril 2013)
Compartir
Compartir
Descargar PDF
Más opciones de artículo
Vol. 20. Núm. 2.
Páginas 70-76 (marzo - abril 2013)
Open Access
Cumplimiento de las recomendaciones de prevención secundaria de enfermedad coronaria en pacientes sometidos a revascularización coronaria percutánea en el Hospital Universitario Fundación Santa Fe de Bogotá
Compliance with recommendations of secondary prevention of coronary heart disease in patients undergoing percutaneous coronary revascularization in the University Hospital Fundación Santa Fe de Bogotá
Visitas
2364
César J. Villalobos1,
Autor para correspondencia
, Carlos A. Carvajal1, Jorge D. Mor1, Iván Rendón1, Laura A. Caycedo2, Valerie J. López2, Silvia Martínez2, Jaime A. Parra2
1 Servicio de Cardiología, Fundación Santa Fe de Bogotá. Bogotá, Colombia
2 Universidad de los Andes. Bogotá, Colombia
Este artículo ha recibido

Under a Creative Commons license
Información del artículo
Marco de referencia

diferentes ensayos clínicos han mostrado que el efecto de las revascularizaciones y los procedimientos de angioplastia en el pronóstico del paciente, tiene sólo un efecto a corto plazo, mientras que la prevención secundaria (cambio de estilo de vida y tratamiento intensivo) mejora el pronóstico a largo plazo.

Objetivo

evaluar el cumplimiento de las recomendaciones para prevención cardiovascular secundaria, de los pacientes sometidos a revascularización coronaria percutánea en el hospital universitario Fundación Santa Fe de Bogotá, entre los años 2008 y 2010.

Materiales y métodos

estudio descriptivo, ambispectivo, cuya población estuvo conformada por 332 pacientes sometidos a intervención coronaria percutánea atendidos entre enero de 2008 a diciembre de 2010 en el servicio de hemodinamia del Hospital Universitario Fundación Santa Fe de Bogotá. La recolección de la información se realizó mediante revisión de las historias clínicas de los pacientes y vía telefónica. Las metas de control se basaron en las recomendaciones de la Asociación Americana del Corazón y el Colegio Americano de Cardiología.

Resultados

332 pacientes fueron sometidos a revascularización coronaria percutánea y 4 fueron excluidos del estudio por falta de datos. La presentación clínica más frecuente fue la angina inestable (32,93%). Sólo se contactaron 172 (52,43%) pacientes, de los cuales 77,4% eran hombres y 22,6% mujeres. Únicamente 6 (3,5%) cumplían con el 100% de las recomendaciones para la prevención secundaria de enfermedad coronaria y 17% cumplía menos del 50% de éstas.

Conclusiones

la experiencia en la Fundación Santa Fe de Bogotá muestra un pobre cumplimiento de las metas de prevención secundaria de enfermedad coronaria.

Palabras clave:
enfermedad coronaria
prevención secundaria
revascularización coronaria percutánea
Context

different clinical trials have shown that the effect of revascularization and angioplasty procedures in the prognosis of the patient has only a short-term effect, while secondary prevention (lifestyle change and intensive treatment) improves long-term prognosis.

Objective

to assess compliance with the recommendations for secondary prevention of cardiovascular disease in patients undergoing percutaneous coronary revascularization at the University Hospital Fundación Santa Fe de Bogotá, between 2008 and 2010.

Materials and methods

a descriptive ambispective study, whose population was conformed by 332 patients undergoing percutaneous coronary intervention seen between January 2008 and December 2010 in the service of hemodynamics of the University Hospital Fundación Santa Fe de Bogotá. The data collection was conducted by reviewing the medical records of the patients and by telephone. Control targets were based on the recommendations of the American Heart Association and the American College of Cardiology.

Results

332 patients underwent percutaneous coronary revascularization. 4 were excluded from the study due to lack of data. The most common clinical presentation was unstable angina (32.93%). Only 172 patients (52.43%) were contacted. From these, 77.4% were male and 22.6% female. Only 6 (3.5%) met 100% of the recommendations for secondary prevention of coronary heart disease and 17% met less than 50% of these recommendations.

Conclusions

the experience in the Fundación Santa Fe de Bogotá shows a poor compliance with the goals of secondary prevention of coronary disease.

Keywords:
coronary disease
secondary prevention
percutaneous coronary revascularization
El Texto completo está disponible en PDF
Bibliografía
[1.]
J. O'Keefe, M. Carter, C. Lavie.
Primary and secondary prevention of cardiovascular diseases.
Mayo Clinic Proc, 84 (2009), pp. 741-757
[2.]
S. Petersen, V. Peto, M. Rayner, J. Leal, R. Luengo-Fernández, A. Gray.
European Cardiovascular Disease Statistics.
British Heart Foundation, (2005),
[3.]
Ministerio de la Protección Social de Colombia. Situación de Salud en Colombia. Indicadores básicos 2006. Bogotá: Ministerio de la Protección Social; 2008.
[4.]
Allender S, Scarborough P, Peto V, Rayner M, Leal J, Luengo-Fernandez R, Gray A. European cardiovascular disease statistics, 2008 edition. British Heart Foundation; 2008. Disponible en: http://www.bhf.org.uk/publications/viewpublication.aspx?ps=1001443. [citado 30 Jun 2011].
[5.]
R. Gupta, P. Deedwania.
Interventions for cardiovascular disease prevention.
Cardiol Clin, 29 (2011), pp. 15-34
[6.]
Ford Es, U.A. Ajani, J.B. Croft, et al.
Explaining the decrease in U.S. deaths from coronary disease, 1980-2000.
N Engl J Med, 356 (2007), pp. 2388-2398
[7.]
S.C. Smith Jr., J. Allen, S.N. Blair, et al.
AHA/ACC guidelines for secondary prevention for patients with coronary and other atherosclerotic vascular disease.
[8.]
S.C. Smith, E.J. Benjamin, R.O. Bonow, L.T. Braun, M.A. Creager.
AHA/ACCF Secondary prevention and risk reduction therapy for patients with coronary and other atherosclerotic vascular disease: 2011 Update.
JACC, 58 (2011), pp. 2432-2446
[9.]
R.D. Brook, P. Greenland.
Secondary prevention.
Preventive cardiology, 2nd, pp. p515e42
[10.]
A. Schömig, J. Mehilli, A. de Waha, M. Seyfarth, J. Pache, A. Kastrati.
A meta-analysis of 17 randomized trials of a percutaneous coronary intervention based strategy in patients with stable coronary artery disease.
J Am Coll Cardiol, 52 (2008), pp. 894-904
[11.]
R.V. Leupker.
Decline in incident coronary heart disease. Why are rates falling?.
Circulation, 117 (2008), pp. 592e3
[12.]
R. Clendenning.
The optimal low-density lipoprotein is 50 to 70 mg/dl.
J Am Coll Cardiol, 45 (2005), pp. 1732
[13.]
Bypass Angioplasty Revascularization Investigation 2 Diabetes (BARI 2D) Study Group.
A randomized trial of therapies for type 2 diabetes and coronary artery disease.
N Engl J Med, 360 (2009), pp. 2503-2515
[14.]
T.R. Frieden, D.M. Berwick.
The “Million Hearts” initiative-preventing heart attacks and strokes.
N Engl J Med, 365 (2011), pp. e27
[15.]
J. Leal, R. Luengo-Fernández, A. Gray, S. Petersen, M. Rayner.
Economic burden of cardiovascular diseases in the enlarged European Union.
Eur Heart J, 27 (2006), pp. 1610-1619
[16.]
V.L. Roger, A.S. Go, D.M. Lloyd-Jones, on behalf of the American Heart Association Statistics Committee and Stroke Statistics Subcommittee, et al.
Heart disease and stroke statistics—2011 update.
Circulation, 123 (2011), pp. e18-e209
[17.]
I. Graham, D. Atar, K. Borch-Johnsen, G. Boysen, G. Burell, et al.
European guidelines on cardiovascular disease prevention in clinical practice.
Eur Heart J, 28 (2007), pp. 2375-2414
[18.]
Grupo de Trabajo de Revascularización Miocárdica de la Sociedad Europea de Cardiología (ESC) y de la Asociación Europea de Cirugía Cardiotorácica (EACTS).
Rev Esp Cardiol, 63 (2010), pp. 1485e1-e14876
[19.]
E. Guarda, M. Acevedo, M.T. Lira, G. Chamorro, R. Corbalán.
Prevalence of cardiovascular risk factors among patients suffering vascular events on admission and one year later.
Rev Med Chil, 133 (2005), pp. 1147-1152
[20.]
The health benefits of smoking cessation. Washington: US Department of Health and Human Services; 1990.
[21.]
A. McEwen, P. Hajek, H. McRobbic, R. West.
Manual of smoking cessation.
Blackwell, (2006),
[22.]
EUROASPIRE Study Group.
European Society of Cardiology survey of secondary prevention of coronary Herat disease: principal results.
Eur Heart J, 18 (1997), pp. 1569-1592
[23.]
EUROASPIRE II Group.
Lifestyle and risk factor management and use of drug therapies in coronary patients: principal results from EUROASPIRE II.
Eur Heart J, 22 (2001), pp. 554-572
[24.]
ALLHAT Officers and Coordinators for the ALLHAT Collaborative Research Group.
Major cardiovascular events in hypertensive patients randomized to doxazosinvschlorthalidone.
JAMA, 283 (2000), pp. 1967-1975
[25.]
W.C. Cushman, C.E. Ford, J.A. Cutler, ALLHAT Collaborative Research Group, et al.
Success and predictors of blood pressure control in diverse North American settings.
J Clin Hypertens (Greenwich), 4 (2002), pp. 393-404
[26.]
Blood Pressure Lowering Treatment Trialists’ Collaboration.
Effects of different regimens to lower blood pressure on major cardiovascular events in older and younger adults.
[27.]
J.A. De Velasco, J. Cosin, J.L. López-Sendón, E. de Teresa, M. de Oya, J.L. Carrasco, et al.
La prevención secundaria del infarto agudo de miocardio en España. Estudio PREVESE.
Rev Esp Cardiol, 50 (1997), pp. 406-415
[28.]
J.A. De Velasco, J. Cosin, J.L. López-Sendón, E. de Teresa, M. de Oya, G. Sellers.
Nuevos datos sobre la prevención secundaria del infarto agudo de miocardio en España. Estudio PREVESE II.
Rev Esp Cardiol, 55 (2002), pp. 801-809
[29.]
P. Poirier, T.D. Giles, G.A. Bray, Y. Hong, J.S. Stern, F.X. Pi-Sunyer, et al.
Obesity and cardiovascular disease.
Circulation, 113 (2006), pp. 898-918
[30.]
F. Fabiani, T. Arrobas, R. Iglesia, J.M. Vega, T. Holgado.
Cumplimiento de objetivos terapéuticos en pacientes con revascularización miocárdica en el Área Virgen Macarena de Sevilla.
Clin Invest Arterioscl, 20 (2008), pp. 1-7
[31.]
C.P. Cannon, E. Braunwald, C.H. McCabe, J.D. Rader, J.L. Rouleau, R. Belder, et al.
Intensive versus moderate lipid lowering with statins after acute coronary syndromes.
N Engl J Med, 350 (2004), pp. 1495-1504
[32.]
Heart Protection Study Collaborative Group.
MRC/BHF. Heart Protection Study of cholesterol lowering with simvastatin in 20536 high-risk individuals: a randomised placebo-controlled trial.
[33.]
H.N. Ginsberg, P. Kris-Etherton, B. Dennis, et al.
Effects of reducing dietary saturated fatty acids on plasma lipids and lipoproteins in healthy subjects: the DELTA Study, protocol 1.
Arterioscler Thromb Vasc Biol, 18 (1998), pp. 441-449
[34.]
B. Howard, L. Van Horn, J. Hsia, J.E. Manson, et al.
Low-fat dietary pattern and risk of cardiovascular disease: the Women’ s Health Initiative Randomized Controlled Dietary Modification Trial.
JAMA, 295 (2006), pp. 655-666
[35.]
A. Rosengren, L. Wilhelmsen.
Physical activity protects against coronary death and deaths from all causes in middle aged men.
Ann Epidemiol, 7 (1997), pp. 69-77
[36.]
R. Taylor, A. Brown, S. Ebrahim, J. Jolliffe, H. Noorani, K. Rees, et al.
Exercise-based rehabilitation for patients with coronary heart disease.
Am J Med, 116 (2004), pp. 682-692
[37.]
Antithrombotic Trialists’ Collaboration.
Collaborative meta- analysis of randomised trials of antiplatelet therapy for prevention of death, myocardial infarction, and stroke in high risk people.
BMJ, 324 (2002), pp. 71-86
[38.]
CURE Trial Investigators.
Effects of clopidogrel in addition to aspirin in patients with acute coronary syndromes without ST-segment elevation.
N Engl J Med, 345 (2001), pp. 494-502
[39.]
N. Freemantle, J. Cleland, P. Young, J. Mason, J. Harrison.
Beta-blockade after myocardial infarction: systematic review and meta regression analysis.
BMJ, 318 (1999), pp. 1730-1737
[40.]
W.E. Boden, R.A. O’Rourke, K.K. Teo, P.M. Hartigan, D.J. Maron, W.J. Kostuk, COURAGE Trial Research Group, et al.
Optimal medical therapy with or without PCI for stable coronary disease.
N Engl J Med, 356 (2007), pp. 1503-1516
[41.]
N.K. Choudhry, J. Avorn, R.J. Glynn, E.M. Antman, S. Schneeweiss.
Full coverage for preventive medications after myocardial infarction.
N Engl J Med, 365 (2011), pp. 2088-2097
[42.]
Third joint task force of European and other societies of cardiovascular disease. Prevention in Clinical Practice.
European Guidelines on Cardiovascular disease prevention in clinical practice.
Eur Heart J, 24 (2003), pp. 1601-1610
[43.]
T.A. Pearson, I. Laurora, H. Chu, S. Kafonek.
The lipid treatment assessment project (L-sTAP).
Arch Intern Med, 160 (2000), pp. 459-467
[44.]
N.K. Choudhry, J. Avorn, R.J. Glynn, E.M. Antman, S. Schneeweiss.
Full coverage for preventive medications after myocardial infarction. Post-Myocardial Infarction Free Rx Event and Economic Evaluation (MI FREEE) Trial.
N Engl J Med, 365 (2011), pp. 2088-2097
Copyright © 2013. Sociedad Colombiana de Cardiología y Cirugía Cardiovascular
Descargar PDF
Opciones de artículo