Originales
Evolución a corto y medio plazo del infarto agudo de miocardio transmural en mujeres ancianas. ¿Son tratadas correctamente?
Short- and mid-term outcomes of Q-wave acute myocardial infarction in elderly women. Are they receiving appropriate treatment?
José G. Galache Osuna
, Cristina Moreno Ambroj, Juan Sánchez-Rubio Lezcano, Isabel Calvo Cebollero, Ana Portolés Ocampo, Carmen Aured Guallar, Jose A. Diarte de Miguel, Luis J. Placer Peralta
Autor para correspondencia
galaruiz@comz.org
Correspondencia: Dr. J.G. Galache Osuna. Servicio de Cardiología. Hospital Universitario Miguel Servet. Isabel la Católica, 1-3. 50009. Zaragoza. España.
Correspondencia: Dr. J.G. Galache Osuna. Servicio de Cardiología. Hospital Universitario Miguel Servet. Isabel la Católica, 1-3. 50009. Zaragoza. España.
Servicio de Cardiología. Hospital Universitario Miguel Servet. Zaragoza. España
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"tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "142" "paginaFinal" => "148" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "José G. Galache Osuna, Cristina Moreno Ambroj, Juan Sánchez-Rubio Lezcano, Isabel Calvo Cebollero, Ana Portolés Ocampo, Carmen Aured Guallar, Jose A. Diarte de Miguel, Luis J. Placer Peralta" "autores" => array:8 [ 0 => array:4 [ "nombre" => "José G." "apellidos" => "Galache Osuna" "email" => array:1 [ 0 => "galaruiz@comz.org" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor1" ] ] ] 1 => array:2 [ "nombre" => "Cristina" "apellidos" => "Moreno Ambroj" ] 2 => array:2 [ "nombre" => "Juan" "apellidos" => "Sánchez-Rubio Lezcano" ] 3 => array:2 [ "nombre" => "Isabel" "apellidos" => "Calvo Cebollero" ] 4 => array:2 [ "nombre" => "Ana" "apellidos" => "Portolés Ocampo" ] 5 => array:2 [ "nombre" => "Carmen" "apellidos" => "Aured Guallar" ] 6 => array:2 [ "nombre" => "Jose A." "apellidos" => "Diarte de Miguel" ] 7 => array:2 [ "nombre" => "Luis J." "apellidos" => "Placer Peralta" ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Servicio de Cardiología. Hospital Universitario Miguel Servet. Zaragoza. España" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "⁎" "correspondencia" => "Correspondencia: Dr. J.G. Galache Osuna. Servicio de Cardiología. Hospital Universitario Miguel Servet. Isabel la Católica, 1-3. 50009. Zaragoza. España." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Short- and mid-term outcomes of Q-wave acute myocardial infarction in elderly women. Are they receiving appropriate treatment?" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2006-08-03" "fechaAceptado" => "2007-02-02" "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec104211" "palabras" => array:4 [ 0 => "Infarto agudo de miocardio" 1 => "Ancianas" 2 => "Fibrinólisis" 3 => "Angioplastia primaria" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec104210" "palabras" => array:4 [ 0 => "Acute myocardial infarction" 1 => "Elderly women" 2 => "Thrombolysis" 3 => "Primary angioplasty" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span class="elsevierStyleSectionTitle">Objetivos</span><p class="elsevierStyleSimplePara elsevierViewall">Dado que el infarto agudo de miocardio (IAM) con onda Q es una afección con elevada mortalidad en mujeres ancianas, intentamos conocer cuál es su evolución actual, su tratamiento y los factores que condicionan el pronóstico.</p> <span class="elsevierStyleSectionTitle">Material y métodos</span><p class="elsevierStyleSimplePara elsevierViewall">Estudio descriptivo que incluyó a todas las mujeres ≥ 75 años con diagnóstico de IAM transmural en el período 2002-2005. Se analizaron las variables epidemiológicas, clínicas, complicaciones vasculares y la evolución durante la estancia intrahospitalaria y a medio plazo. Se compararon estas variables según hubieran recibido en fase aguda terapia de reperfusión o no, y se registró el motivo de no recibir ese tratamiento.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">Se incluyó a 152 mujeres; la edad media fue de 82,2<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>6,2 años. Un 34,2% eran diabéticas y con IAM anterior en el 40,8%; el 27% tenía un grado Killip III-IV. Se realizó tratamiento de revascularización en fase aguda al 21,1%. La mortalidad intrahospitalaria fue del 25,8% y la acumulada a 6 meses del 37,3%. La incidencia de eventos mayores al año fue 43,8%. No recibir terapia de reperfusión estuvo condicionado por. la edad, el bloqueo de la rama izquierda, la demora en acudir al hospital y por decisión médica. La mortalidad fue 3,3 veces menor en el grupo tratado, aunque con un riesgo relativo de complicación hemorrágica del 2,5. Además de la ausencia de tratamiento revascularizador, el grado Killip y la fracción de eyección fueron predictores independientes de mortalidad.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">El IAM en las ancianas continúa siendo una afección con elevada morbimortalidad. A pesar del beneficio observado, estas pacientes reciben escasa terapia de reperfusión en fase aguda, aunque no existe contraindicación formal en la mitad de los casos.</p>" ] "en" => array:2 [ "titulo" => "Summary" "resumen" => "<span class="elsevierStyleSectionTitle">Objectives</span><p class="elsevierStyleSimplePara elsevierViewall">Q-wave acute myocardial infarction leads to high mortality in elderly women. The aim of this study was to determine current outcomes, treatment and prognostic factors in these patients.</p> <span class="elsevierStyleSectionTitle">Material and methods</span><p class="elsevierStyleSimplePara elsevierViewall">All women aged ≥75 with Q-wave acute myocardial infarction admitted to our hospital from 2002-2005 were included in this descriptive study. Epidemiological and clinical variables, vascular complications, intra-hospital outcomes, and mid-term follow-up were analyzed and compared depending on whether reperfusion therapy was administered on admission or not. The reasons for not administering this therapy were recorded.</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">We included 152 women. The mean age was 82.2 years (SD 6.2). A total of 34.2% had diabetes and 40.8% had anterior myocardial infarction. Killip class III-IV was found in 27.0%. Reperfusion therapy was administered to 21.1% of the patients. Intra-hospital mortality was 25.8% and 6-month mortality was 37.3%. The incidence of major cardiac events at 1 year was 43.8%. Non-administration of reperfusion therapy was related to age, left bundle-branch block, delayed admission, and medical decision. Mortality was 3.3 times lower in treated patients, although the relative risk of hemorrhagic complications was 2.5 times higher than that in non-treated patients. Independent predictors of mortality were lack of reperfusion therapy, high Killip class on admission, and low ejection fraction.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">Acute myocardial infarction in elderly women continues to cause high morbidity and mortality. Reperfusion therapy is little used in this group of patients, despite the observed benefits. Half these patients have no contraindications for reperfusion therapy.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:30 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." 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| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Octubre | 7 | 3 | 10 |
| 2024 Septiembre | 23 | 11 | 34 |
| 2024 Agosto | 16 | 2 | 18 |
| 2024 Julio | 10 | 9 | 19 |
| 2024 Junio | 13 | 12 | 25 |
| 2024 Mayo | 8 | 13 | 21 |
| 2024 Abril | 17 | 6 | 23 |
| 2024 Marzo | 13 | 13 | 26 |
| 2024 Febrero | 14 | 11 | 25 |
| 2024 Enero | 18 | 9 | 27 |
| 2023 Diciembre | 16 | 10 | 26 |
| 2023 Noviembre | 24 | 21 | 45 |
| 2023 Octubre | 25 | 35 | 60 |
| 2023 Septiembre | 24 | 16 | 40 |
| 2023 Agosto | 7 | 5 | 12 |
| 2023 Julio | 15 | 8 | 23 |
| 2023 Junio | 12 | 4 | 16 |
| 2023 Mayo | 7 | 4 | 11 |
| 2023 Abril | 11 | 1 | 12 |
| 2023 Marzo | 12 | 4 | 16 |
| 2023 Febrero | 13 | 7 | 20 |
| 2023 Enero | 5 | 5 | 10 |
| 2022 Diciembre | 19 | 7 | 26 |
| 2022 Noviembre | 21 | 2 | 23 |
| 2022 Octubre | 16 | 25 | 41 |
| 2022 Septiembre | 15 | 8 | 23 |
| 2022 Agosto | 14 | 13 | 27 |
| 2022 Julio | 14 | 11 | 25 |
| 2022 Junio | 10 | 10 | 20 |
| 2022 Mayo | 8 | 9 | 17 |
| 2022 Abril | 17 | 12 | 29 |
| 2022 Marzo | 8 | 18 | 26 |
| 2022 Febrero | 12 | 6 | 18 |
| 2022 Enero | 24 | 14 | 38 |
| 2021 Diciembre | 48 | 6 | 54 |
| 2021 Noviembre | 22 | 16 | 38 |
| 2021 Octubre | 18 | 5 | 23 |
| 2021 Septiembre | 5 | 13 | 18 |
| 2021 Agosto | 8 | 5 | 13 |
| 2021 Julio | 16 | 7 | 23 |
| 2021 Junio | 12 | 9 | 21 |
| 2021 Mayo | 12 | 8 | 20 |
| 2021 Abril | 31 | 12 | 43 |
| 2021 Marzo | 24 | 12 | 36 |
| 2021 Febrero | 13 | 5 | 18 |
| 2021 Enero | 8 | 10 | 18 |
| 2020 Diciembre | 14 | 10 | 24 |
| 2020 Noviembre | 11 | 6 | 17 |
| 2020 Octubre | 8 | 6 | 14 |
| 2020 Septiembre | 12 | 11 | 23 |
| 2020 Agosto | 16 | 11 | 27 |
| 2020 Julio | 8 | 11 | 19 |
| 2020 Junio | 11 | 4 | 15 |
| 2020 Mayo | 11 | 17 | 28 |
| 2020 Abril | 8 | 7 | 15 |
| 2020 Marzo | 15 | 9 | 24 |
| 2020 Febrero | 6 | 11 | 17 |
| 2020 Enero | 9 | 17 | 26 |
| 2019 Diciembre | 9 | 20 | 29 |
| 2019 Noviembre | 3 | 12 | 15 |
| 2019 Octubre | 8 | 10 | 18 |
| 2019 Septiembre | 6 | 16 | 22 |
| 2019 Agosto | 7 | 16 | 23 |
| 2019 Julio | 17 | 39 | 56 |
| 2019 Junio | 15 | 54 | 69 |
| 2019 Mayo | 61 | 95 | 156 |
| 2019 Abril | 17 | 103 | 120 |
| 2019 Marzo | 3 | 20 | 23 |
| 2019 Febrero | 6 | 24 | 30 |
| 2019 Enero | 8 | 30 | 38 |
| 2018 Diciembre | 6 | 22 | 28 |
| 2018 Noviembre | 2 | 29 | 31 |
| 2018 Octubre | 21 | 45 | 66 |
| 2018 Septiembre | 7 | 9 | 16 |
| 2018 Agosto | 2 | 16 | 18 |
| 2018 Julio | 3 | 13 | 16 |
| 2018 Junio | 0 | 13 | 13 |
| 2018 Mayo | 0 | 18 | 18 |
| 2018 Abril | 2 | 14 | 16 |
| 2018 Marzo | 0 | 4 | 4 |
| 2018 Febrero | 0 | 3 | 3 |
| 2018 Enero | 0 | 4 | 4 |
| 2017 Diciembre | 2 | 3 | 5 |
| 2017 Noviembre | 1 | 6 | 7 |
| 2017 Octubre | 3 | 1 | 4 |
| 2017 Septiembre | 6 | 17 | 23 |
| 2017 Agosto | 9 | 2 | 11 |
| 2017 Julio | 2 | 3 | 5 |
| 2017 Junio | 10 | 10 | 20 |
| 2017 Mayo | 3 | 3 | 6 |
| 2017 Abril | 8 | 1 | 9 |
| 2017 Marzo | 5 | 30 | 35 |
| 2017 Febrero | 9 | 0 | 9 |
| 2017 Enero | 8 | 1 | 9 |
| 2016 Diciembre | 16 | 2 | 18 |
| 2016 Noviembre | 22 | 3 | 25 |
| 2016 Octubre | 25 | 7 | 32 |
| 2016 Septiembre | 19 | 6 | 25 |
| 2016 Agosto | 9 | 1 | 10 |
| 2016 Julio | 9 | 1 | 10 |
| 2016 Junio | 22 | 4 | 26 |
| 2016 Mayo | 15 | 10 | 25 |
| 2016 Abril | 25 | 2 | 27 |
| 2016 Marzo | 23 | 5 | 28 |
| 2016 Febrero | 22 | 6 | 28 |
| 2016 Enero | 27 | 9 | 36 |
| 2015 Diciembre | 30 | 9 | 39 |
| 2015 Noviembre | 21 | 2 | 23 |
| 2015 Octubre | 31 | 5 | 36 |
| 2015 Septiembre | 20 | 8 | 28 |
| 2015 Agosto | 7 | 5 | 12 |
| 2015 Julio | 17 | 4 | 21 |
| 2015 Junio | 14 | 3 | 17 |
| 2015 Mayo | 15 | 3 | 18 |
| 2015 Abril | 13 | 13 | 26 |
| 2015 Marzo | 16 | 3 | 19 |
| 2015 Febrero | 34 | 2 | 36 |
| 2015 Enero | 41 | 3 | 44 |
| 2014 Diciembre | 38 | 5 | 43 |
| 2014 Noviembre | 27 | 2 | 29 |
| 2014 Octubre | 27 | 0 | 27 |
| 2014 Septiembre | 26 | 1 | 27 |
| 2014 Agosto | 23 | 2 | 25 |
| 2014 Julio | 31 | 1 | 32 |
| 2014 Junio | 46 | 1 | 47 |
| 2014 Mayo | 26 | 1 | 27 |
| 2014 Abril | 19 | 4 | 23 |
| 2014 Marzo | 19 | 4 | 23 |
| 2014 Febrero | 16 | 3 | 19 |
| 2014 Enero | 20 | 5 | 25 |
| 2013 Diciembre | 22 | 4 | 26 |
| 2013 Noviembre | 22 | 7 | 29 |
| 2013 Octubre | 19 | 2 | 21 |
| 2013 Septiembre | 19 | 6 | 25 |
| 2013 Agosto | 12 | 1 | 13 |
| 2013 Julio | 8 | 0 | 8 |
| 2007 Abril | 827 | 0 | 827 |
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