Determinants of the clinical presentation of acute coronary syndromes.

Introduction: Two clinical presentations of acute coronary syndrome (ACS) have been defined: ST- segment elevation ACS (STEACS) or non-ST-segment elevation ACS (NSTEACS). The mechanism that determines the clinical presentation of ACS is not clearly understood. The aim of this study was to define the association between cardiovascular risk factors and other clinical variables with the clinical presentation of ACS as STEACS or NSTEACS.

Sex Differences in the Clinical Presentation of Acute Coronary Syndromes.

The clinical presentation of acute coronary syndromes (ACS) as ST-elevation ACS (STEACS) or non-ST-elevation ACS (NSTEACS) differs between women and men. The aim of this study was to describe the difference in the clinical presentation of ACS between sexes. A total of 10,019 patients included in the Epi-Cardio Registry were analyzed.

An analysis of death trends in Argentina, 1990-2017, with emphasis on the effects of economic crises.

Background: Economic crises have heterogeneous effects on population-level mortality between high- and low- or middle-income countries. Argentina - a middle income country- has suffered economic crises repeatedly over the past 30 years and is a model case study for the effects of economic crises on mortality.

Methods: Over 28 years (1990-2017), all death records in Argentina were analysed at the most disaggregated level possible (departments, that is, second-level administrative divisions).

[Acute coronary syndromes in public and non-public institutions of Argentina].

Treatment of acute coronary syndrome (ACS) may differ according to the health system coverage. The objective of this study was to evaluate demographic characteristics of patients with ACS assisted in public sector institutions compared to the non-public sector of Argentina, as well as the therapeutic and its relationship with the resources of each sector. We analyzed patients hospitalized in institutions of a national, voluntary, prospective and multicenter registry.

Cardiovascular and other risk factors among people who live in slums in Buenos Aires, Argentina.

Objectives: Effective planning of health policies requires the availability of accurate data, representing the burden of disease and risks to the diverse components of society. In Argentina, health information comes from the national risk factors survey (NRFS), which characterises the distribution of different risk factors. However, the NRFS has never collected information from residents living in slums, despite slums representing 10% of the population.

Patients' perceptions of argentine physicians' empathy based on the jefferson scale of patient's perceptions of physician empathy: Psychometric data and demographic differences.

Background: The aim of this study was to evaluate the validity of a modified Spanish version of the Jefferson Scale of Patient's Perceptions of Physician Empathy (JSPPPE) in Argentine patients and to explore how local demographic characteristics influence patients' perceptions of their physicians' empathy.

Methods: A survey was conducted in March 2013 among 400 Spanish-speaking outpatients attending three different public or private hospitals of Buenos Aires. A principal component analysis (PCA) was used to identify the JSPPPE factor structure, and a confirmatory factor analysis (CFA) was employed to evaluate its construct validity.

Measurement of empathy among Argentine cardiologists: Psychometrics and differences by age, gender, and subspecialty.

Background: Cardiologists are involved in the management of patients with multiple cardiovascular risk factors and chronic heart diseases, so empathy is a necessary feature to deal with them. The aim of the study was to evaluate the validity and reliability of the Spanish version of the Jefferson Scale of Physician Empathy (JSPE) among Argentine cardiologists and to explore the potential differences by age, gender, and subspecialty.

Methods: Between August and September 2012, we performed a survey in a non-randomized sample of 566 Spanish-speaking cardiologists of Argentina.

Analysis of the invasive strategy decision in patients with acute coronary syndrome without ST-segment elevation in a real-world setting.

Observational studies have reported a marked discrepancy between the risk estimated by scores and the use of an invasive strategy in patients with acute coronary syndromes. The objective is to describe the criteria used to decide an early invasive strategy and to determine the differences between those criteria and the thrombolysis in myocardial infarction risk score (TRS). Patients entered to the Epi-Cardio registry with a diagnosis of non-ST-elevation acute coronary syndrome were analyzed.

[Diffusion and adoption of health care innovations in cardiology, in Argentina].

Background: Medicine is changing rapidly and diagnostic and therapeutic innovations are common. Not all professionals adopt these innovations in the same way.

Aim: To survey the physicians' opinions on adopting innovations in cardiovascular health care, to classify individuals from an innovative to a conservative behavior, and to individualize opinion leaders among them, in order to build a social network of influence.

Survey on Ethical Conduct Thresholds in Cardiologal Medical Practice in Argentina.

The purpose of this study was to analyze the attitude of a group of cardiologists on the ethical conducts they would accept or adopt when encountered with different hypothetical situations of medical practice. Between August and September of 2011, 700 Argentine cardiologists were surveyed in situations which posed ethical dilemmas in the patient-physician relationship, among colleagues or involving financial agreements with employers or the pharmaceutical industry. Ethical conflicts were evidenced in a series of inappropriate conducts such as differential fees, trips and meals sponsored by laboratories, splitting fees, overbilling, self-referral, charging for patient referral, financial compensation for ordering medical procedures, and various situations derived from the relationship with employers.

N-3 polyunsaturated fatty acids to prevent atrial fibrillation: updated systematic review and meta-analysis of randomized controlled trials.

Background: Previous studies have suggested that n-3 polyunsaturated fatty acids (n-3 PUFAs) have antiarrhythmic effects on atrial fibrillation (AF). We aimed to assess the effects of therapy with n-3 PUFAs on the incidence of recurrent AF and on postoperative AF.

Methods And Results: Electronic searches were conducted in Web of Science, Medline, Biological Abstracts, Journal Citation Reports, and the Cochrane Central Register of Controlled Trials databases.

Omega-3 fatty acids for the prevention of recurrent symptomatic atrial fibrillation: results of the FORWARD (Randomized Trial to Assess Efficacy of PUFA for the Maintenance of Sinus Rhythm in Persistent Atrial Fibrillation) trial.

Objectives: The aim of this study was to evaluate the efficacy of polyunsaturated fatty acids (n-3 PUFA) for the prevention of recurrent atrial fibrillation (AF) in patients with normal sinus rhythm.

Background: Current pharmacological treatments to limit recurrent AF in patients with previous AF have limited efficacy and high rates of adverse events. Results of trials that tested the efficacy of n-3 PUFA provided heterogeneous results.

[Patients' preferences for information in health care decision-making].

A survey was carried out among patients who concurred to cardiologic services to know how patients preferred to be informed about their health status, and the demographic characteristics associated to these preferences, considering the following items: knowledge about the disease, information about different therapeutic options and decision-making. From 770 people surveyed, 738 (95.8%) answered the form completely.

Noninvasive ventilation in acute cardiogenic pulmonary edema: a meta-analysis of randomized controlled trials.

Background: The evidence of individual studies in acute cardiogenic pulmonary edema (ACPE) supporting noninvasive ventilation (NIV) is still inconclusive, particularly regarding noninvasive positive pressure ventilation (NIPPV).

Methods: We carried out a meta-analysis. We searched in the Embase, Medline, Cinahl, Dare, Coch, Central, and CNKI databases and congress abstracts for trials comparing continuous positive airway pressure (CPAP) or NIPPV with standard therapy (ST).

Long-term results after a telephone intervention in chronic heart failure: DIAL (Randomized Trial of Phone Intervention in Chronic Heart Failure) follow-up.

Objectives: The purpose of this study was to assess the rate of death and hospitalization for heart failure (HF) 1 and 3 years after a randomized trial of telephone intervention aimed to improve education and compliance in stable patients with HF ended.

Background: The long-term effects of HF programs are not well known.

Methods: In all, 1,518 patients with HF were randomized into the DIAL (Randomized Trial of Phone Intervention in Chronic Heart Failure).

Early assessment of myocardial viability by the use of delayed enhancement computed tomography after primary percutaneous coronary intervention.

Objectives: We sought to explore the relationship between established parameters of reperfusion and the extent of myocardial damage measured by the delayed enhancement (DE) of iodinated contrast by multidetector computed tomography (MDCT) immediately after primary percutaneous coronary intervention (PCI).

Background: Early detection of myocardial viability should be valuable for risk stratification of patients with reperfused acute myocardial infarction (AMI).

Methods: Consecutive patients without a history of previous AMI who underwent primary PCI for an ST-segment elevation AMI were examined by DE-MDCT without an additional contrast injection immediately after completion of PCI.

[Survey of medical attitudes towards a "case scenario" of encephalopathy after cardiac arrest].

Recent studies have shown that the timing of death is often under the control of the physicians who treat the patient in intensive care unit (ICU), where death is commonly preceded by decisions either not to start an aggressive therapy or to discontinue life-sustaining therapy. The objective was to study end-of-life decisions and attitudes of Argentinian cardiologists when treating terminal patients in the ICU. During 2007, a survey by e-mail was carried out among 967 cardiologists across Argentina.

The rationale and design of the FORomegaARD Trial: A randomized, double-blind, placebo-controlled, independent study to test the efficacy of n-3 PUFA for the maintenance of normal sinus rhythm in patients with previous atrial fibrillation.

Background: Atrial fibrillation (AF) is associated with increased risk of death, thromboembolic complications, and a lowered quality of life. Despite this burden, pharmacologic agents for prevention of AF in patients who achieved normal sinus rhythm are of limited utility, mostly because of serious and frequent side effects. Thus, the availability of safer and more effective drugs may reduce the burden of disease.

Perception of consultation length in cardiology and its ethical implications.

Objectives: This study considered whether the time employers allotted to medical consultations in many working environments in Argentina might be inadequate to carry out an interview. The objective was to conduct a survey to gather information on the length of cardiologic medical consultations in Argentina.

Methods: During 2007, a survey was carried out that included 816 cardiologists.

Ethical review and informed consent in cardiovascular research reports in Argentina.

Background: Requirements for Institutional Review Board approval and informed consent for research involving human subjects have existed for more than 2 decades. However, evidence of fulfillment of these requirements is sometimes lacking in cardiovascular research reports in Argentina. Since ethical standards vary between committees, there may be some confusion among researchers regarding the need for an ethical review when conducting low risk research.

Omega-3 fatty acid supplementation reduces one-year risk of atrial fibrillation in patients hospitalized with myocardial infarction.

Purpose: Current strategies for avoiding atrial fibrillation (AF) are of limited value. We aim to assess the relationship between omega-3 fatty acids (n-3 PUFA) and AF occurrence in post-myocardial infarction (MI) patients.

Methods: A population study, linking hospital discharge records, prescription databases, and vital statistics, was conducted and included all consecutive patients with MI (ICD-9: 410) in six Italian local health authorities over a 3-year period.

Seasonal variation and trends in heart failure morbidity and mortality in a South American community hospital.

Circannual variation in cardiovascular events is well-known. Seasonal variation (SV) in heart failure (HF) has been described in the Northern Hemisphere, but there is scarcity of data in South America. The goals of the present study were to (1) describe the SV of admissions and deaths for HF, and (2) describe trends in HF morbidity and mortality in a community hospital in Argentina from 1992 to 1999.