medigraphic.com
ISSN 2078-7170 (Electronic)

2013, Number 4

<< Back Next >>

CorSalud 2013; 5 (4)

Cardiovascular risk factors and quality of life in women who underwent revascularization with coronary stenting

Castillo NJC, Llerena RLR, Castillo NJ, Vistorte VY, Romero SA, de Armas RY

Language: Spanish
References: 62
Page: 334-345
PDF size: 533.27 Kb.


ABSTRACT

Introduction: Cardiovascular risk factors are directly responsible for the high mortality from atherosclerotic coronary artery disease in women.
Objective: To describe these risk factors, the clinical course and quality of life in women after coronary angioplasty.
Method: A descriptive, longitudinal prospective study was conducted in women (n=62) who underwent revascularization with PTCA and stent implantation from January to June 2011. Clinical follow-up was performed for 180 days through medical consultations.
Results: The mean age was 52.8 years and the most frequent cardiovascular risk factor was hypertension (66.1 %); diabetes (24.2 %) was the least prevalent. One-vessel atherosclerotic coronary artery disease was the most common (87.1%), and three-vessel disease (1.6%) was the least frequent one. Only one stent was implanted in 75.8 % of patients, and only one patient required the implantation of three stents; 83.9% of patients expressed that their quality of life was good, 14.5 % considered it was acceptable and one patient estimated it was poor. During clinical follow-up, no cardiovascular events was reported in 93.5 % of patients. Diabetes and poor quality of life showed a statistically significant association with the extent of atherosclerotic coronary artery disease, the number of stents used and cardiovascular events.
Conclusions: Women with atherosclerotic coronary artery disease who underwent revascularization with coronary stents show a high frequency of risk factors, and have a favorable clinical course with a prevalence of positive perceptions concerning their quality of life.


REFERENCES

  1. Hamm CW, Bassand JP, Agewall S, Bax J, Boersma E, Bueno H, et al. Guía de práctica clínica de la ESC para el manejo del síndrome coronario agudo en pacientes sin elevación persistente del segmento ST. Rev Esp Cardiol. 2012;65(2):173.e1-e55.

  2. Ministerio de Salud Pública; Dirección Nacional de Registros Médicos y Estadísticas de Salud. Anuario Estadístico de Salud 2011 [Internet]. La Habana: MINSAP; 2012. Disponible en: http://files.sld.cu/bvscuba/files/2012/05/anuario-2011-e.pdf

  3. Díaz Rodríguez A. Las dislipidemias como factor de riesgo cardiovascular. Prevención primaria y pre-vención secundaria en Atención Primaria. Madrid: Saned; 2009. Disponible en: http://2011.elmedicointeractivo.com/Documentos/doc/21_DISLIPEMIAS_FAC_EMId.pdf

  4. Moreno Martínez FL. The New England Journal of Medicine, CorSalud y las enfermedades cardiovas-culares. Revista Finlay [Internet]. 2012 [citado 2013 May 12];2(1):6-7. Disponible en: http://www.revfinlay.sld.cu/index.php/finlay/article/view/106/113

  5. Lloyd-Jones D, Adams R, Carnethon M, De Simone G, Ferguson TB, Flegal K, et al. Heart disease and stroke statistics – 2009 Update: A report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation. 2009;119(3):480-6.

  6. Achury D, Rodríguez-Colmenares SM, Agudelo-Contreras LA, Hoyos-Segura JR, Acuña-Español JA. Calidad de vida del paciente con enfermedad cardiovascular que asiste al programa de reha-bilitación cardiaca. Investig Enferm Imagen Desarr. 2011;13(2):49-74

  7. Díaz Corral IB. Determinantes psicológicos de la calidad de vida [Tesis doctoral]. La Habana: Universidad de Ciencias Médicas de La Habana; 2008. [Internet]. Disponible en: http://tesis.repo.sld.cu/182/1/Ileana_Diaz_.pdf

  8. Seldinger SI. Catheter replacement of the needle in percutaneous arteriography; A new technique. Acta Radiol. 1953;39(5):368-76.

  9. Judkins MP. Selective coronary arteriography, part I: a percutaneous transfemoral technic. Radiology 1967;89(5):815-24.

  10. 10.Aldeman EL, Stadius ML. The angiographic defini-tions of the bypass Angioplasty Revascularization Investigation (BARI). Coron Artery Dis. 1992;3: 1189-1207.

  11. 11.Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL, et al. The Seventh Report of the Joint National Committee on Prevention, De-tection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA 2003;289(19): 2560-72.

  12. 12.World Health Organization. Definition, diagnosis and classification of diabetes mellitus and its com-plications. Report of a WHO Consultation. Geneva: World Health Organization; 1999. Disponible en: http://www.who.int/diabetes/publications/Definition%20and%20diagnosis%20of%20diabetes_new.pdf

  13. 13.Braunwald E. Unstable angina: A classification. Circulation.1989;80(2):410-4.

  14. 14.Mendis S, Thygesen K, Kuulasmaa K, Giampaoli S, Mähönen M, Ngu Blackett K, et al. World Health Organization definition of myocardial infarction: 2008-09 revision. Int J Epidemiol. 2011;40(1):139-46.

  15. 15.World Medical Association Declaration of Helsinki. Ethical principles for medical research involving hu-man subjects. 59th WMA General Assembly, Seoul, October 2008; [Internet]. Disponible en: http://www.wma.net/en/30publications/10policies/b3/17c.pdf

  16. 16.de la Iglesia B, Potter JF, Poulter NR, Robins MM, Skinner J. Performance of the ASSIGN cardiovas-cular disease risk score on a UK cohort of patients from general practice. Heart 2011;97(6):491-9.

  17. 17.Wong ND. American Society for Preventive Cardiol-ogy Annual Debate: Coronary heart disease in men and momen – Does one size fit all?. Clin Cardiol. 2011;34(11):653.

  18. 18.Wenger NK. Cardiovascular disease: the female heart is vulnerable: a call to action from the 10Q report. Clin Cardiol. 2012;35(3):134-5.

  19. 19.Hurtado-Martínez J, Pinar-Bermúdez E, Teruel-Ca-rrillo F, Gimeno-Blanes JR, Lacunza-Ruiz J, Valdesu-so R, et al. Mortalidad a corto y largo plazo en mu-jeres con infarto de miocardio tratado con angio-plastia primaria. Rev Esp Cardiol. 2006;59(11):1113-22.

  20. 20.Leyva Quert AY, Conde Pérez P, Méndez Peralta T, Almeida Gómez J, Valdés Recarey M, Claro Valdez R. Seguimiento a mediano plazo tras la implanta-ción de stents coronarios convencionales en muje-res. Rev Cubana Med. 2009;48(3):48-58.

  21. 21.Concepción González V, Ramos González HL. Comportamiento de factores de riesgo cardiovascu-lar en ancianos del consultorio “La Ciénaga”. Cor-Salud [Internet]. 2012 [citado 2013 May 15];4(1): 30-38. Disponible en: http://bvs.sld.cu/revistas/cors/pdf/2012/v4n1a12/es/frc.pdf

  22. 22.Andrés E, León M, Cordero A, Magallón R, Magán P, Luengo E, et al. Factores de riesgo cardiovascular y estilo de vida asociados a la aparición prematura de infarto agudo de miocárdio. Rev Esp Cardiol. 2011; 64(6):527-9.

  23. 23.Puymirat E, Simon T, Steg PG, Schiele F, Guéret P, Blanchard D, et al. Association of changes in clinical characteristics and management with improvement in survival among patients with ST-elevation myo-cardial infarction. JAMA. 2012;308(10) :998-1006.

  24. 24.Roger VL, Go AS, Lloyd-Jones DM, Adams RJ, Berry JD, Brown TM, et al. Heart Disease and Stroke Sta-tistics–2011 Update: A Report from the American Heart Association. Circulation. 2011;123(4):e18-209.

  25. 25.Egan BM, Zhao Y, Axon RN. US trends in preva-lence, awareness, treatment, and control of hyper-tension, 1988-2008. JAMA. 2010;303(20): 2043-50.

  26. 26.Gabriel R, Alonso M, Segura A, Tormo MJ, Artigao LM, Banegas JR, et al. Prevalencia, distribución y variabilidad geográfica de los principales factores de riesgo cardiovascular en España. Análisis agru-pado de datos individuales de estudios epidemioló-gicos poblacionales: estudio ERICE. Rev Esp Cardiol. 2008;61(10):1030-40.

  27. 27.Boutitie F, Gueyffier F, Pocock S, Fagard R, Boissel JP; INDANA Project Steering Committee - Individual Data Analysis of Antihypertensive intervention. J-shaped relationship between blood pressure and mortality in hypertensive patients: New insights from a meta-analysis of individual-patient data. Ann Intern Med. 2002;136(6):438-48.

  28. 28.Messerli FH, Mancia G, Conti CR, Hewkin AC, Kupfer S, Champion A, et al. Dogma disputed: Can aggressively lowering blood pressure in hyperten-sive patients with coronary artery disease be dan-gerous? Ann Intern Med. 2006;144(12):884-93.

  29. 29.ACCORD Study Group, Cushman WC, Evans GW, Byington RP, Goff DC, Grimm RH, et al. Effects of intensive blood-pressure control in type 2 diabetes mellitus. N Engl J Med. 2010;362(17):1575-85.

  30. 30.Cooper-DeHoff RM, Gong Y, Handberg EM, Bavry AA, Denardo SJ, Bakris GL, et al. Tight blood pressure control and cardiovascular outcomes among hypertensive patients with diabetes and coronary heart disease. JAMA. 2010;304(1):61-8.

  31. 31.Denardo SJ, Messerli FH, Gaxiola E, Aranda JM, Cooper-Dehoff RM, Handberg EM, et al. Charac-teristics and outcomes of revascularized patients with hypertension: An international verapamil SR-trandolapril substudy. Hypertension. 2009;53(4): 624-30.

  32. 32.Bavry AA, Anderson RD, Gong Y, Denardo SJ, Cooper-Dehoff RM, Handberg EM, et al. Outcomes among hypertensive patients with concomitant peripheral and coronary artery disease: Findings from the INternational VErapamil-SR/trandolapril Study. Hypertension. 2010;55(1);48-53.

  33. 33.Denardo SJ, Messerli FH, Gaxiola E, Aranda JM, Cooper-Dehoff RM, Handberg EM, et al. Coronary revascularization strategy and outcomes according to blood pressure (from the International Verapa-mil SR-Trandolapril Study [INVEST]). Am J Cardiol. 2010;106(4):498-503.

  34. 34.Bangalore S, Qin J, Sloan S, Murphy SA, Cannon CP; PROVE IT-TIMI 22 Trial Investigators. What is the optimal blood pressure in patients after acute coro-nary syndromes?: Relationship of blood pressure and cardiovascular events in the PRavastatin OR atorVastatin Evaluation and Infection Therapy-Thrombolysis In Myocardial Infarction (PROVE IT-TIMI) 22 trial. Circulation. 2010;122(21):2142-51.

  35. 35.Lundberg G, King S. Coronary revascularization in women. Clin Cardiol. 2012;35(3):156-9.

  36. 36.Barge-Caballero E, Vázquez-Rodríguez JM, Estévez-Loureiro R, Calviño-Santos R, Salgado-Fernández J, Aldama-López G, et al. Angioplastia primaria en el Área Norte de Galicia: cambios asistenciales y resul-tados tras la implantación del programa PROGALIAM. Rev Esp Cardiol. 2012;65(4):341-9.

  37. 37.Crudu V, SartoriusJ, Berger P, Scott T, Skelding K, Blankenship J. Middle-of-the-night PCI does not affect subsequent day PCI success and complication rates by the same operator. Catheter Cardiovasc Interv. 2012;80(7):1149-54.

  38. 38.Song PS, Ryu DR, Choi SH, Yang JH, Song YB, Hahn JY, Choi JH, Seung KB, Park SJ, Gwon HC. Impact of acute coronary syndrome classification and proce-dural technique on clinical outcomes in patients with coronary bifurcation lesions treated with drug-eluting stents. Clin Cardiol. 2012;35(10):610-8.

  39. 39.Pacheco González G, Obregón Santos ÁG, Aroche Aportela R, Conde Cerdeira H, Hernández Navas M, Gandarilla Sarmientos JC. Factores clínicos y del procedimiento relacionados con la trombosis de stent. CorSalud [Internet]. 2012 [citado 2013 May 21];4(2):97-102. Disponible en: http://bvs.sld.cu/revistas/cors/pdf/2012/v4n2a12/es/trombosis.pdf

  40. 40.Splansky GL, Corey D, Yang Q, Atwood LD, Cupples LA, Benjamin EJ, et al. The Third Generation Cohort of the National Heart, Lung, and Blood Institute's Framingham Heart Study: design, recruitment, and initial examination. Am J Epidemiol. 2007;165(11): 1328-35.

  41. 41.O´Donnel CJ, Elosua R. Factores de riesgo cardio-vascular. Perspectivas derivadas del Framingham Heart Study. Rev Esp Cardiol. 2008;61(3);299-310.

  42. 42.Bueno H, Fernández-Avilés F. Use of risk scores in acute coronary syndromes. Heart. 2012;98(2):162-8.

  43. 43.Thanassoulis G, Peloso GM, Pencina MJ, Hoffmann U, Fox CS, Cupples LA, et al. A genetic risk score is associated with incident cardiovascular disease and coronary artery calcium: the Framingham Heart Study. Circ Cardiovasc Genet. 2012;5(1):113-21.

  44. 44.Cholesterol Treatment Trialists’ (CTT) Collabor-ation, Baigent C, Blackwell L, Emberson J, Holland LE, Reith C, et al. Efficacy and safety of more intensive lowering of LDL cholesterol: a meta-analysis of data from 170.000 participants in 26 randomised trials. Lancet. 2010;376(9753):1670-81.

  45. 45.Khera AV, Cuchel M, de la Llera-Moya M, Rodrigues A, Burke MF, Jafri K, et al. Cholesterol efflux capa-city, high-density lipoprotein function, and atheros-clerosis. N Engl J Med. 2011;364(2):127-35.

  46. 46.Arroyave JA, Cepeda MC. Caracterización de la res-tenosis de stents coronarios convencionales y liberadores de medicamentos en pacientes incluidos en el registro DRug Eluting STent (DREST). Rev Colomb Cardiol. 2012;19(3):121-31.

  47. 47.Kim MJ, Jeon DS, Gwon HC, Kim SJ, Chang K, Kim HS, Tahk SJ. Current statin usage for patients with acute coronary syndrome undergoing percutaneous coronary intervention: Multicenter survey in Korea. Clin Cardiol. 2012;35(11):700-6.

  48. 48.Zylbersztejn H, Giorgi M. Evaluación global de los factores de riesgo cardiovascular. cálculo del ries-go. Rev Argent Cardiol. 2012;80(Supl 2):10-21.

  49. 49.Segovia J, Bermejo J, Alfonso F. Resumen de los en-sayos clínicos presentados en la 57.a Sesión Cientí-fica Anual del American College of Cardiology (Chi-cago, Estados Unidos, 30 de marzo-2 de abril de 2008). Rev Esp Cardiol. 2008;61(7):726-37.

  50. 50.Ray KK, Seshasai SR, Wijesuriya S, Sivakumaran R, Nethercott S, Preiss D, et al. Effect of intensive control of glucose on cardiovascular outcomes and death in patients with diabetes mellitus: A meta-analysis of randomised controlled trials. Lancet. 2009;373(9677):1765-72.

  51. 51.Action to Control Cardiovascular Risk in Diabetes Study Group, Gerstein HC, Miller ME, Byington RP, Goff DC, Bigger JT, et al. Effects of intensive glucose lowering in type 2 diabetes. N Engl J Med. 2008; 358(24):2545-59.

  52. 52.Serrano Ricardo G, Pérez del Todo JM, del Pino Sán-chez E. Evolución clínica de pacientes con infarto agudo de miocardio tratados con angioplastia pri-maria. CorSalud [Internet]. 2012 [citado 2013 May 21];4(3):157-65. Disponible en: http://bvs.sld.cu/revistas/cors/pdf/2012/v4n3a12/es/actp.pdf

  53. 53.Ravelo Dopico R, Heres Álvarez FC, López Ferrero L, Pérez del Todo JM, González Grek O, Rodríguez Londres J. Factores pronósticos de eventos cardia-cos adversos en pacientes tratados mediante inter-vencionismo coronario percutáneo electivo. Rev Cubana Cardiol Cir Cardiovasc [Internet]. 2010 [ci-tado 2013 May 21];16(4):407-16. Disponible en: http://www.revcardiologia.sld.cu/index.php/revcardiologia/article/download/210/162

  54. 54.Park DW, Seung KB, Kim YH, Lee JY, Kim WJ, Kang SJ, et al. Long-term safety and efficacy of stenting versus coronary artery bypass grafting for unpro-tected left main coronary artery disease: 5-year results from the MAIN-COMPARE (Revasculari-zation for Unprotected Left Main Coronary Artery Stenosis: Comparison of Percutaneous Coronary Angioplasty Versus Surgical Revascularization) re-gistry. J Am Coll Cardiol. 2010;56(2):117-24.

  55. 55.Díaz JF, de La Torre JM, Sabaté M, Goicolea J. Regis-tro Español de Hemodinámica y Cardiología Inter-vencionista. XXI Informe Oficial de la Sección de Hemodinámica y Cardiología Intervencionista de la Sociedad Española de Cardiología (1990-2011). Rev Esp Cardiol. 2012;65(12):1106-16.

  56. 56.American College of Cardiology; American Heart Association Task Force on Practice Guidelines. 2007 Focused Update of the ACC/AHA/SCAI 2005 Guide-line Update for Percutaneous Coronary Interven-tion. A report of the American College of Cardiol-ogy/American Heart Association Task Force on Practice Guidelines. Catheter Cardiovasc Interv. 2008;71(1):E1-40.

  57. 57.Warnes CA, Williams RG, Bashore TM, Child JS, Connolly HM, Dearani JA, et al: ACC/AHA 2008 guidelines for the management of adults with con-genital heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Com-mittee to Develop Guidelines on the Management of Adults With Congenital Heart Disease). Developed in Collaboration With the American Society of Echocardiography, Heart Rhythm Society, Inter-national Society for Adult Congenital Heart Disease, Society for Cardiovascular Angiography and Inter-ventions, and Society of Thoracic Surgeons. J Am Coll Cardiol. 2008;52(23): e143-e263.

  58. 58.Falcón Lincheta L, Martínez Cardoso B. Dermatosis provocadas por la luz solar e influencia en la calidad de vida. Rev Cubana Med Militar [Internet]. 2012 [citado 2013 May 21];41(3): 248-55. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_pdf&pid=S0138-65572012000300004&lng=es&nrm=iso&tlng=es

  59. 59.Capote Leyva E, Casamayor Laime Z, Castañer Moreno JC. Calidad de vida y depresión en el adulto mayor con tratamiento sustitutivo de la función renal. Rev Cubana Med Militar [Internet]. 2012 [citado 2013 May 24];41(3): 237-47. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_pdf&pid=S0138-65572012000300003&lng=es&nrm=iso&tlng=es

  60. 60.Blasco SA. Cuestionarios de calidad de vida. Aspec-tos teóricos. Alergol Inmunol Clin. 2001;16(4):239-44.

  61. 61.Mele EF. Prevención secundaria en la enfermedad coronaria en 2012: análisis de algunos aspectos más allá de la prescripción de fármacos. CorSalud [Internet]. 2012 [citado 2013 May 21];4(2):80-86. Disponible en: http://bvs.sld.cu/revistas/cors/pdf/2012/v4n2a12/es/prevencion.pdf

  62. 62.Wenger NK. Current status of cardiac rehabilit-ation. J Am Coll Cardiol. 2008;51(17):1619-31.




2020     |     www.medigraphic.com