Rev Esp Cardiol
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Comparative Study
[Comparison of the management of non-ST segment elevation myocardial infarction during emergency care according to sex of the patient].
The atypical characteristics of acute coronary syndrome in women lead to differences in management and treatment. We investigated these differences in the urgent management of non-ST-segment acute myocardial infarction (NSTEMI). ⋯ The trend to fewer admissions to coronary or intensive care units (42.9% vs 55.6%) and fewer catheterization procedures (29.7% vs 40.7%) disappeared after adjustment. We conclude that there are virtually no differences in treatment in women with N-STEMI in prehospital and emergency care.
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Many patients with severe aortic stenosis never undergo surgical treatment for various reasons. Apart from the standard risks, some patients face an additional problem: their carrying of a mechanical mitral valve. ⋯ This paper reports the cases of 3 patients with severe aortic stenosis, all carrying a mechanical mitral valve and at high surgical risk, all of whom were implanted by transcatheter aortic valve implantation with an Edwards aortic valve prosthesis. All procedures were successful with no complications encountered.
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To examine the extent to which the decrease in coronary heart disease mortality rates in Spain between 1988 and 2005 could be explained by changes in cardiovascular risk factors and by the use of medical and surgical treatments. ⋯ Approximately half of the coronary heart disease mortality fall in Spain was attributable to reductions in major risk factors, and half to evidence-based therapies. These results increase understanding of past trends and will help to inform planning for future prevention and treatment strategies in low-risk populations.
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Randomization of treatment assignment in experiments generates treatment groups with approximately balanced baseline covariates. However, in observational studies, where treatment assignment is not random, patients in the active treatment and control groups often differ on crucial covariates that are related to outcomes. These covariate imbalances can lead to biased treatment effect estimates. ⋯ Critically, propensity score designs should be created without access to outcomes, mirroring the separation of study design and outcome analysis in randomized experiments. This paper describes the potential outcomes framework for causal inference and best practices for designing observational studies with propensity scores. We discuss the use of propensity scores in two studies assessing the effectiveness and risks of antifibrinolytic drugs during cardiac surgery.
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The Sociedad Española de Cardiología (Spanish Society of Cardiology) every year awards grants to finance research in the field of cardiovascular diseases. The aim of this study is to identify the impact of these investments during the period 2000-2006 from the subsequently published articles in scientific journals. ⋯ During the period 2000 to 2006, the Sociedad Española de Cardiología/ Fundación Española del Corazón (Spanish Heart Foundation) provided about €500,000 per year to fund research grants, thereby contributing to the fight against cardiovascular diseases. Almost 60% of grants have led to publications, 73% of which were published in international journals, and 91.34% in national or international journals with an impact factor in the Journal Citation Reports.