González-Pliego José Angel, Gutiérrez-Díaz Gonzalo Israel, Celis Alfredo, Gudiño-Amezcua Diego Armando
Departamento de Cardiología Clínica, Unidad Médica de Alta Especialidad, Hospital de Especialidades, Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Guadalajara, Jalisco, México.
Departamento de Cardiología Clínica, Unidad Médica de Alta Especialidad, Hospital de Especialidades, Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Guadalajara, Jalisco, México.
Arch Cardiol Mex. 2014 Apr-Jun;84(2):92-9. doi: 10.1016/j.acmx.2013.11.006. Epub 2014 May 1.
To describe the clinical-epidemiologic profile and the process of care of the non-ST elevation acute coronary syndromes in a tertiary hospital.
We analyzed the clinical information, the risk stratification and diagnostic methods, the revascularization therapy and the prescription trends at discharge, of patients with non-ST elevation acute coronary syndromes cared for in one year.
Two hundred and eighty-three patients with mean age of 58 years were included (63% men). The largest number of non-ST elevation acute coronary syndromes (88.6%) was found between 50 to 59 years of age. The most common risk factor was hypertension; 82.5% of the patients had a low-intermediate TIMI score; residual ischemia was demonstrated in 37% and coronary obstructions were seen in 80 patients (70%). In 90%, a percutaneous coronary intervention was performed, mainly with drug-eluting Stents (87.5%). At discharge, even though antiplatelet agents and statins were prescribed in more than 90%, other drugs were indicated in a few more than 50% of patients.
In this population, non-ST elevation acute coronary syndromes predominates in relatively young men, often with hypertension. To stratify risk, to look for residual ischemia and to revascularize with drug-eluting stents are common practices, but the evidence-based guidelines compliance is still suboptimal.
描述一家三级医院非ST段抬高型急性冠状动脉综合征的临床流行病学特征及治疗过程。
我们分析了一年内接受治疗的非ST段抬高型急性冠状动脉综合征患者的临床信息、风险分层和诊断方法、血运重建治疗及出院时的处方趋势。
纳入283例患者，平均年龄58岁（男性占63%）。非ST段抬高型急性冠状动脉综合征患者数量最多的年龄段为50至59岁（占88.6%）。最常见的危险因素是高血压；82.5%的患者TIMI评分低至中度；37%的患者存在残余缺血，80例（70%）患者可见冠状动脉阻塞。90%的患者接受了经皮冠状动脉介入治疗，主要使用药物洗脱支架（87.5%）。出院时，尽管超过90%的患者开具了抗血小板药物和他汀类药物，但超过50%的患者还开具了其他药物。
在该人群中，非ST段抬高型急性冠状动脉综合征在相对年轻的男性中占主导，常伴有高血压。进行风险分层、寻找残余缺血并使用药物洗脱支架进行血运重建是常见做法，但基于证据的指南依从性仍不理想。
