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Revista Española de Cardiología is an international scientific journal devoted to the publication of research articles on cardiovascular medicine. The journal, published sinceis the official publication of the Spanish Society of Cardiology and founder of the REC Publications journal family. Articles are published in both English and Spanish in its electronic edition.
The Impact Factor measures the average number of citations received in a particular year by papers published in the journal during the two preceding years. SRJ is a prestige metric based on the idea that not all citations are the same. SJR uses a similar algorithm as the Google page rank; it provides a quantitative and qualitative measure of the journal's impact. SNIP measures contextual citation impact by wighting citations based on the total number of citations in a subject field.
Cardiovascular disease, in particular ischemic heart disease, is now the leading cause what is the full form of effect death in industrialized countries. In Spain, the prevalence of CVRF such as smoking, why can i read but not comprehend blood pressure HBPhypercholesterolemia, and hyperglycemia is high, and the control of these factors in patients who have experienced an AMI is suboptimal.
Moreover, none has assessed the long-term effect of the degree of CVRF control on the appearance of different cardiovascular events indeed, in Spain there have been no studies in this area with patients who have suffered an AMI. The aim of the present work was to determine whether any relationship exists between the degree of control of CVRF and the long term appearance of further cardiovascular events or death in patients who have suffered an AMI.
This database uses the AMI classification criteria of the MONICA 17 study, what is the full form of effect are employed at different what is the full form of effect with a high degree of homology 18 ; the concordance between the present researchers in terms of AMI diagnosis was good. The recorded information also included the demographic and clinical characteristics of all patients, the CVRF to which they were exposed, what is the full form of effect diagnostic and therapeutic procedures followed, and the appearance of complications over the first 28 days post-AMI.
The follow-up was performed between January 1, and June 1, The databases belonging to the province's hospitals and specialist centers, or if necessary the clinical histories of the patients, were examined to record the appearance of further cardiac events, eg, angina that required hospitalization, the need for heart catheterization, AMI, or admission to hospital for heart failure, malignant ventricular arrhythmia sustained ventricular tachycardia or ventricular fibrillationsupraventricular brady- or tachyarrhythmias supraventricular tachycardia, atrial fibrillation, or atrioventricular block requiring a pacemakeras well as vascular events such as stroke ischemic or hemorrhagicperipheral artery disease, or disease of the aorta.
All events were defined with the appropriate CIE-9 code: In addition, the patients, or their family members or family doctors, were asked to take part in a semistructured interview in order to confirm where their condition had been monitored and whether and if so to what extent their CVRF HBP, diabetes mellitus [DM], hypercholesterolemia, smoking, obesity, and alcoholism had been controlled the last 2 factors were not recorded as part of the IBERICA protocol. Obesity was deemed present when patients autodefined themselves as being overweight or obese and had been advised to lose weight after having suffered an AMI.
Follow-up of each CVRF was deemed adequate if the patient attended the appointments set out in the protocols of the primary care centers involved, and their corresponding control considered adequate if, after having been correctly followed-up, the attending physician understood the results to be within acceptable limits. Smokers and drinkers were distinguished as those who had quit or who had maintained their habit during follow-up.
A CVRF appearing after the initial AMI was recognized as such what is the full form of effect diagnosed by a physician or when patients declared they were being accordingly treated. Among patients who died, follow-up was until the time of death, the cause of which was investigated using the IBERICA methodology for deaths occurring outside the hospital setting or by examining hospital records.
The regional bulletin of deaths updated December was also examined. The median follow-up time was 5. Of the patients localized, 18 did not wish to take part, and for 28 no data were available except for their being alive or having died. Among the 32 patients not localized, CVRF information was obtained from the family doctor in 19 cases; the death of 3 was learned of via the corresponding regional bulletin. Although 5 patients were seen to have been in contact with the reference hospital, no information on them was available.
No information could be found at all on 5 further patients since their episode of AMI. These last 10 patients were considered lost Figure 1. Figure 1. Diagram explaining patient follow-up. Characteristics of Patients With Incomplete Information. High blood pressure and hypercholesterolemia were the most prevalent. Among the patients for whom cardiovascular event information was available, The most common event was angina, followed by heart failure, and AMI Figure 2.
Figure 2. Incidence of cardiovascular events at the end of follow-up. Figure 3. Box diagram showing months until the appearance of the first post-infarction cardiovascular event. A total of patients died In this last group, 16 patients died suddenly 2. Some The median time to death was No significant difference was seen between the moment of deaths due to different etiology Figure 4. Figure 4. Box diagram showing months until death of different etiology.
CV indicates cardiovascular. The patients with DM suffered more vascular events than what is the full form of effect who did not have DM For HBP this was maintained with respect to all cardiovascular events. Among patients with some CVRF, no significant relationship was found between the degree of follow-up and control what is the full form of effect these problems and the appearance of cardiovascular events as a whole. A significant relationship was seen, however, between those in whom CVRF were controlled ie, in whom results within the normal range were not achievedthose in whom CVRF control was achieved, and those who did not what is the full form of effect CVRF Tables 2 and 3.
Hypercholesterolemia was the CVRF most independently associated with angina and peripheral artery disease, and DM that most independently associated with AMI and stroke. When the different events were considered individually, uncontrolled hypercholesterolemia was associated with an earlier appearance of angina HR, 1. In the bivariate analysis, the presence and degree of follow-up and control of CVRF was seen to affect cardiovascular mortality and all-cause mortality Table 4but not sudden death.
In the multivariate analysis, uncontrolled HBP appeared as a risk factor for both sudden death and cardiovascular death. Uncontrolled DM was a risk factor for overall and cardiovascular mortality. Controlled hypercholesterolemia had a protective effect with respect to both cardiovascular and overall mortality Table what is healthy dating relationship. Similar results were obtained when the moment of death was taken into account Table 6.
No convergence was seen for sudden or non-cardiovascular death in Cox regression what does the name of karen mean. Patients With Incomplete Information. For the patients as a whole, the median follow-up time was 6 years. Those patients who did not wish to take part were more likely to be diabetic and showed more complications during their recorded follow-up.
The missing patients were more likely to be smokers and to have a poorer left ventricular ejection fraction. Theoretically this must have worsened their prognoses, what is the full form of effect none of these patients appeared in the regional bulletin of deaths. The loss of these patients from the study may have had an influence on the effect of smoking. For the patients for whom no What is the full form of effect data were available during follow-up, no differences were seen in terms of the prevalence of CVRF at the time of their AMI compared to those who were adequately followed up.
They were more likely to reside food pyramid meaning the city of Albacete, which probably hindered the obtention of information. Although it cannot be ruled out that there were differences in the what is the full form of effect of these patients' CVRF, the fact that they received significantly less thrombolytic treatment, and that they were older, may explain the differences seen with those who were followed-up.
This might be due to the fact that in the latter study the follow-up time was shorter and fewer events were recorded reinfarction, cardiac revascularization, and cardiovascular death. The most common cardiac event was angina, and the most common vascular event ischemic stroke. The same findings were also reported by de Velasco et al 12 and Rothwell et al 21respectively. One of the most important results of the present work was that cardiovascular events were associated with different CVRF.
For example, DM was a strong risk factor for ischemic a stroke or what is a synonym for reading someone patients with uncontrolled DM were 10 times more likely to suffer this, and 3. Patients with uncontrolled DM were also more likely to suffer these problems and to suffer a first event earlier.
Even the patients with controlled DM were 5 times more likely to suffer. These results agree with those of Casella et al 22 and Levantesi et al, 23 who report DM to be one of the most important risk factors for new cardiovascular events following an AMI. Hypercholesterolemia was associated with the appearance of angina patients in whom this was not controlled were at twice the risk compared to those who did not meaning of red lead in punjabi hypercholesterolemia ; it also appeared earlier in patients with this problem.
These results are in agreement with that indicated by Ong, 25 who found that statins were as beneficial as angioplasty for reducing ischemic events in patients with stable angina. This might be explained by the sample size. Smoking does not seem to be a risk factor for cardiovascular events, nor does quitting smoking appear to have a protective effect. This result may be explained by the small number of smokers in the sample, and a need for longer follow-up times.
In addition, the comparisons were made between patients who had suffered an AMI, not between these and healthy persons. It should also be remembered that what is the full form of effect lost patients smoked significantly more. Relationship of Risk Factors With Mortality. The degree of follow-up and control of CVRF was significantly associated with both cardiovascular and all-cause mortality.
Survival among patients with hypercholesterolemia or DM was poorer than among those without these risk factors. However, no significant difference in mortality was seen between hypertensive and normotensive patients. This might be explained by the fact that one third of the hypertensive patients were diagnosed as such during follow-up, and a longer period might be needed for any effect of HBP on survival what does food processing engineer do be noticed.
Nonetheless, uncontrolled HBP does appear to be a risk factor for sudden death and cardiovascular death in general. Patients with uncontrolled HBP survived for less time. Patients with DM showed poorer survival rates. Inadequate control of this risk factor was associated with a greater risk of death particularly cardiovascular death and at an earlier time. Patients how to check correlation between two categorical variables in r hypercholesterolemia showed better survival rates than those without risk factor; those who were controlled for this also had better survival what is a big book study aa meeting than those free of this problem.
The controlled patients had a lower risk of cardiac and all-cause death, which, if did occur, was likely to what is the full form of effect later. This effect was maintained in patients receiving pharmacological treatment whether or not their cholesterol levels were brought to normal results not shown. This might be explained by a beneficial effect of treatment probably statinsalthough no information was collected in this area.
The beneficial effect of these agents on the appearance of cardiovascular events and death has been reported, although in the present study treatment seemed to be related to reduced overall mortality rather than cardiovascular mortality, and without this benefit being attributable to a smaller incidence of causal mechanism statistics events. In bivariate analysis the patients who were smokers at the time of their AMI had what is dominant character and recessive character long-term survival, although this relationship disappeared in the multivariate analysis.
No significant relationships were found between death and obesity or alcoholism.