Características de hallazgos clínicos, electrocardiográficos y angiográficos de pacientes jóvenes con infarto agudo de miocardio en una clínica de IV nivel de la ciudad de Barranquilla
| datacite.rights | http://purl.org/coar/access_right/c_16ec | spa |
| dc.contributor.advisor | Cotes Aroca, Carlos Hernán | |
| dc.contributor.advisor | Urina Triana, Manuel | |
| dc.contributor.author | Clavijo Tinoco, Fair De Jesús | |
| dc.contributor.author | Fuentes Pinto, Shally Shaydi | |
| dc.date.accessioned | 2024-01-17T21:56:15Z | |
| dc.date.available | 2024-01-17T21:56:15Z | |
| dc.date.issued | 2023 | |
| dc.description.abstract | Introducción: Estudios realizados en diversas poblaciones señalan una conexión entre los principales factores de riesgo de enfermedad coronaria arteriosclerótica y la aparición directa del síndrome coronario agudo (SCA), especialmente el infarto agudo de miocardio (IAM), en individuos mayores de 55 años. En personas menores de 55 años, este fenómeno se asocia con mayor frecuencia a hipercoagulabilidad, vasculitis, vasoespasmo endógeno o vasoespasmo mediado por sustancias tóxicas, subestimando o ignorando los factores de riesgo fundamentales para la enfermedad coronaria como causa directa en esta población. Objetivo: Caracterizar los hallazgos clínicos, electrocardiográficos y angiográficos de pacientes jóvenes con infarto agudo de miocardio en una clínica de IV nivel de la ciudad de Barranquilla. Material y métodos: Estudio observacional-descriptivo, retrospectivo de corte transversal, con un total de 136 pacientes que ingresaron por el servicio de hemodinamia con diagnóstico de infarto agudo de miocardio que cumplieran los criterios de inclusión y se sometieron a cateterismo cardiaco izquierdo. El muestreo se llevó a cabo en una institución prestadora de salud (IPS) de alta complejidad durante el periodo comprendido entre enero del 2019 y mayo de 2023 en la ciudad de Barranquilla, Colombia. Se verificó en base de datos de servicio de hemodinamia variables sociodemográficas (edad, género) antropométricas [peso, talla, índice de masa corporal (IMC)], comorbilidades [hipertensión arterial (HTA), diabetes mellitus, (DM), obesidad, dislipidemia] y estilos de vida (tabaquismo, alcohol y consumo de drogas), resultado de biomarcador cardiaco tipo troponina de alta sensibilidad (PATHFAST TM hs-cTnI). El análisis de los datos obtenidos se llevó a cabo utilizando el Software: Minitab 20.3 ®. El estudio de asociación entre las variables cualitativas (categórica) se realizó por medio de la prueba chicuadrado y ANOVA, y para datos cuantitativos medidas de tendencia central, y para comparar variables t de student. 5 Resultados: 136 pacientes cumplieron con criterios de inclusión, de los cuales el 77,2% eran hombres, con una mediana de edad de 48 años. Los factores de riesgo más frecuentes fueron la hipertensión arterial 78,7%; el 40.4 % dislipidemia y el 33.1% diabetes. La mayor frecuencia de pacientes presentó un índice masa corporal entre 25 y 29.9 kg/m2 . La característica clínica más común al ingreso fue KK I (99.9%). Siendo más frecuente el infarto en los segmentos basales. El 61.76% de los pacientes presentaron IAMSEST de los cuales el 17.87 % (n=15) manifestaron un patrón electrocardiográfico de alto riesgo. A través de angiografía coronaria se evidenció enfermedad aterotrombótica en el 75% y coronaria sin lesiones en el 25 % de los pacientes. La enfermedad monovascular fue la más frecuente 30.8%. El vaso más afectado fue la ADA ( 50,7%). La fracción de eyección promedio fue de 50.34 %. El número total de pacientes con compromiso de la función sistólica del ventrículo izquierdo fue de 63 (47%). El procedimiento de revascularización miocárdica (RVM) fue realizado en el 69 % de los pacientes, destacándose la angioplastia con implantación de stent como la intervención más frecuente en este grupo, llevada a cabo en un 73.4% de los casos. Se trombolizó al 8.92% de la población estudiada. Conclusión: Se estableció que la población estudiada es menor de 50 años, en sobrepeso, cuya manifestación principal fue dolor de origen cardiaco con diagnóstico más incidente el IAMSEST sin patrones de alto riesgo, siendo los factores de riesgo más frecuentes la hipertensión, la dislipidemia y la diabetes. La enfermedad monovascular fue la más frecuente siendo la ADA el vaso el mayor porcentaje de obstrucción. Los pacientes egresaron con terapia médica indica DF da por guías que incluída estatinas betabloqueadores IECAS/ ARA 2, doble antiagregación plaquetaria siendo el segundo antiagregante mayor utilizado el clopidogrel. | spa |
| dc.description.abstract | Introduction: Studies conducted in various populations indicate a connection between the main risk factors for arteriosclerotic coronary artery disease and the direct onset of acute coronary syndrome (ACS), especially acute myocardial infarction (AMI), in individuals over 55 years old. In individuals under 55 years old, this phenomenon is more frequently associated with hypercoagulability, vasculitis, endogenous vasospasm, or vasospasm mediated by toxic substances, often underestimating or disregarding the fundamental risk factors for coronary disease as a direct cause in this population. Objective: Characterize the clinical, electrocardiographic, and angiographic findings of young patients with acute myocardial infarction at a level IV clinic in the city of Barranquilla. Material and methods: This is a cross-sectional, retrospective observationaldescriptive study involving 136 patients admitted through the emergency department with a diagnosis of acute myocardial infarction who met the inclusion criteria and underwent left heart catheterization. The sampling was conducted at a high-complexity healthcare institution during the period from January 2019 to May 2023 in Barranquilla, Colombia. Sociodemographic variables (age, gender), anthropometric measures (weight, height, body mass index (BMI)), comorbidities (hypertension (HTA), diabetes mellitus (DM), obesity, dyslipidemia), and lifestyle factors (smoking, alcohol, and drug consumption) were verified in medical records. The study also examined the results of high-sensitivity troponin cardiac biomarker (PATHFAST TM hs-cTnI). Data analysis was performed using Minitab 20.3® software. The association between qualitative (categorical) variables was assessed through chi-square and ANOVA tests, and for quantitative data, measures of central tendency were used, with student's t-test employed to compare variables. | eng |
| dc.format.mimetype | spa | |
| dc.identifier.uri | https://hdl.handle.net/20.500.12442/13808 | |
| dc.language.iso | spa | spa |
| dc.publisher | Ediciones Universidad Simón Bolívar | spa |
| dc.publisher | Facultad de Ciencias de la Salud | spa |
| dc.rights | Attribution-NonCommercial-NoDerivatives 4.0 Internacional | * |
| dc.rights.accessrights | info:eu-repo/semantics/restrictedAccess | spa |
| dc.rights.uri | http://creativecommons.org/licenses/by-nc-nd/4.0/ | * |
| dc.subject | Infarto agudo de miocardio | spa |
| dc.subject | Joven | spa |
| dc.subject | Ruptura de placa | spa |
| dc.subject | Factor de riesgo | spa |
| dc.subject | Angiografía | spa |
| dc.subject | Acute myocardial infarction | eng |
| dc.subject | Young | eng |
| dc.subject | Plaque rupture | eng |
| dc.subject | Risk factor | eng |
| dc.subject | Angiography | eng |
| dc.title | Características de hallazgos clínicos, electrocardiográficos y angiográficos de pacientes jóvenes con infarto agudo de miocardio en una clínica de IV nivel de la ciudad de Barranquilla | spa |
| dc.type.driver | info:eu-repo/semantics/other | spa |
| dc.type.spa | Otros | spa |
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| oaire.version | info:eu-repo/semantics/acceptedVersion | spa |
| sb.programa | Especialización en Medicina Interna | spa |
| sb.programa | Especialización en Cardiología | spa |
| sb.sede | Sede Barranquilla | spa |