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The Glenn Shunt Revisited, A Single Center Registry in Ain Shams University cardiology department

Congenital Heart Disease 2022年第1期17卷 71-85页

作者： Mina Tewfik Maiy El-Sayed Alaa Roushdy Soha Romeih Dina Ezzeldin Hebatalla Attia cardiology department Ain Shams UniversityCairoEgypt Prof.Magdy Yacoub Aswan Heart Centre AswanEgypt cardiology department Tanta UniversityTantaEgypt

Background:Bidirectional Glenn shunts have long been available as palliative procedures for patients with single ventricle physiology that is,patients unsuitable for biventricular repair.In our country they are performed at an older age than that recommended by the literature.So,we aim to assess post bidirectional Glenn shunt patients to detect the presence of any complications and to evaluate their functional capacity.Methods:This was a descriptive study that included all patients who underwent a bidirectional Glenn shunt and were referred for follow up in Ain shams university hospitals.History taking including NYHA class and physical activity,clinical examination,six-minutes-walk test,laboratory investigations,full echocardiographic assessment were done for all patients.Some patients needed invasive cardiac catheterization.Results:Our registry included 178 patients who underwent bidirectional Glenn procedure referred for follow up in Ain Shams university hospital from January 2019 till July 2020.The mean age of the registry was 18.7±8.26 years(range between 5 and 37 years),85 males(48%)and 93 females(52%).Regarding the basic anatomy,double outlet right ventricle with hypoplastic left ventricle was the commonest.Furthermore,our descriptive study confirmed many characteristic similarities between our patients and patients in developing countries.Our patients underwent bidirectional Glenn shunt at a median age of 6 years which is considered a relatively old age but similar to other studies that have been made in developing countries like Pakistan,India and Iran.There is a significant delay in the operation in Egyptian patients due to lack of patients’awareness,few numbers of primary health care facilities and high economic burden.Conclusion:Although the presence of slight systemic desaturation,our study demonstrated a satisfactory functional capacity among our patients;thus,bidirectional Glenn can be considered an acceptable definite univentricular repair in patients with late presentation.

关键词： Bidirectional Glenn shunt single ventricle univentricular repair

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Correlation between SYNTAX Score and Pattern of Risk Factors in Patients Referred for Coronary Angiography in cardiology department, Menoufia University

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World Journal of Cardiovascular Diseases 2018年第8期8卷 431-439页

作者： Ahmed Mokhtar El Kersh Ahmed Ashraf Reda Mohamed Gamal El Hadad Khaled Hussein El-Sharnouby department of cardiology Menoufia University Hospitals Menoufia Egypt department of cardiology Shibin El Kom Teaching Hospital Menoufia Egypt

Objectives: The role of SYNTAX (SX) score in assessing the complexity of coronary artery disease (CAD) is well established. In this study we investigate the relationship between conventional risk factors of CAD with its complexity using SX score. Methods: The study consisted of 52 patients with CAD who were admitted to cardiology department—Menoufia University Hospitals for elective coronary angiography. The overall SX score was calculated prospectively using the SX score algorithm. Then comparison was done between populations with and without each risk factor. Results: There was a statistically significant correlation between age, hypertension, diabetes mellitus, dyslipidemia and smoking with SX score results (p 0.05). In a multivariate regression analysis, including conventional risk factors of CAD as independent covariates, it revealed that aging, having diabetes mellitus and smoking were identified as significant independent risk factors for CAD complexity. Conclusion: Advanced age, having diabetes mellitus and cigarette smoking are considered to be independent risk factors for the complexity of CAD. Therefore, when these factors present, we expect that the SX score of the patient to be high indicating a complex CAD.

关键词： Coronary Artery Disease SYNTAX Score Risk Factors

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Pulmonary Embolism in Hospitalization in the Department of Cardiology of Gabriel Toure University Hospital

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World Journal of Cardiovascular Diseases 2018年第1期8卷 18-23页

作者： Ichaka Menta Souleymane Coulibaly Hamidou Oumar Ba Djénébou Traore Mougnon Walbane Youssouf Camara Ibrahima Sangare Illo Bela Diall Samba Sidibé Noumou Sidibé Mamadou Diakité Coumba Thiam Kassoum Sanogo cardiology department Gabriel Touré Hospital Bamako Mali CHU Point G cardiology department Bamako Mali department of Internal Medicine and Endocrinology Mali Hospital Bamako Mali Kati Hospital Center cardiology Service Bamako Mali

Objective: The aim of this study was to describe the epidemiological, clinical and Para clinical characteristics in patients hospitalized for pulmonary embolism in the cardiology department of Gabriel Toure University Hospital. Methodology: It was a retrospective and descriptive study from January 2011 to December 2014 and involved all patients hospitalized during the study period. Results: The study included 21 patients out of 1738 hospitalized patients, with a prevalence of 1.21%. The mean age was 38.57 years with extreme ages of 18 and 64 years. The sex ratio was 0.40. Risk factors found in the study were oral contraception (19.05%), overweight (19.05%), smoking (14.28%), HIV (4.76%) and heart failure (4, 76%). 61.90% (n = 13) had isolated pulmonary embolism, 38.09% (n = 8) had venous thrombosis and pulmonary embolism association. Through the chest angio-CT, 28.57% of obstructions were located at the left branch of the pulmonary artery, 9.52% at the right branch and 61.90% were bilateral obstructions. Four deaths were recorded, all in a context of massive pulmonary embolism, with a fatality rate of 19.05%. Conclusion: Pulmonary embolism is a serious and common disease, often difficult to diagnose. It is a cardiovascular emergency and requires immediate and adequate care.

关键词： Pulmonary Embolism cardiology Gabriel Toure Hospital

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Prospective application of a bleeding and ischemic risks-adjusted antithrombotic protocol in elderly patients revascularized with everolimus-eluting stents:EPIC05-Sierra75 study

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Journal of Geriatric cardiology 2022年第5期19卷 354-366页

作者： Jose M de la Torre Hernandez Ramon Lopez Palop Jesus M Jimenez Mazuecos Pilar Carrillo Sáez Alejandro Gutierez-Barrios Eduardo Pinar Belen Cid Luis Fernandez Tamara Garcia Camarero Cristóbal Urbano-Carrillo Juan F Oteo Dominguez Victor A Jimenez Diaz Antonio EGomez Menchero Eladio Galindo Fernández Juan GCórdoba Soriano Raymundo Ocaranza Eduardo ArroyoÚcar Koldobika Garcia San Roman Silvio Leal Ginés Martínez Cáceres Jose A Linares Vicente Georgina Fuertes Ferre Xavier Carrillo Juan CRama Merchán Catia Costa Juan Sanchis Renato Fernandes Alberto Rodrigues Jose M Vegas Valle Hélder Pereira Armando Perez de Prado cardiology department Hospital Universitario Marqués de ValdecillaIDIVALSantanderSpain cardiology department Hospital Universitario San JuanAlicanteSpain cardiology department Complejo Hospitalario Universitario de AlbaceteAlbaceteSpain cardiology department Hospital Universitario Puerta del MarCadizSpain cardiology department Hospital Clínico Universitario Virgen de la ArrixacaMurciaSpain cardiology department Hospital Clinico Universitario de SantiagoCIBERCVSantiago de CompostelaSpain cardiology department Hospital Universitario de CrucesBilbaoSpain cardiology department Hospital Regional Universitario de MálagaMalagaSpain cardiology department Hospital Universitario Puerta de HierroMadridSpain cardiology department Hospital Alvaro CunqueiroVigoSpain cardiology department Hospital Juan Ramon JimenezHuelvaSpain cardiology department Hospital Universitario de BadajozBadajozSpain cardiology department Hospital Universitario Lucus AugustiLugoSpain cardiology department Hospital de Torrevieja/VinalopóRibera SaludTorreviejaSpain cardiology department Hospital Santa CruzLisboaPortugal cardiology department Hospital Clínico Universitario Lozano BlesaZaragozaSpain cardiology department Hospital Universitario Miguel ServetZaragozaSpain cardiology department Hospital Germans Trias i PujolBadalonaSpain cardiology department Hospital de MeridaMeridaSpain cardiology department Hospital São BernardoSetúbalPortugal cardiology department Hospital Clinico Universitario de ValenciaUniversidad de ValenciaCIBERCVValenciaSpain cardiology department Hospital do Espirito SantoEvoraPortugal cardiology department Centro Hospitalar de Vilanova de GaiaVilanova de GaiaPortugal cardiology department Hospital de CabueñesGijonSpain cardiology department Hospital Garcia de OrtaAlmadaPortugal cardiology department Complejo Asistencial Universitario de LeónLeonSpain

OBJECTIVES Elderly patients show a higher incidence of ischemic and bleeding events after percutaneous transluminal coron-ary intervention(PCI).We sought to investigate outcomes in elderly patients treated with antithrombotic strategy guided by bleeding and ischemic risks after revascularization with last generation everolimus-eluting stent(EES).METHODS Prospective multicenter registry including patients over 75 years revascularized with EES and antithrombotic ther-apy guided by clinical presentation,PCI complexity and PRECISE DAPT score.Co-primary safety endpoints were:(1)composite of cardiac death,myocardial infarction and stent thrombosis and;(2)bleeding(BARC 2-5).Primary efficacy endpoint was target lesion revascularization.A matched group of patients revascularized with current drug-eluting stents and no such tailored antith-rombotic therapy was used as control.RESULTS Finally,1064 patients were included in SIERRA-75 cohort,80.8±4.2 years,36.6%women,71%acute coronary syn-dromes(ACS)and 53.6%complex PCI.Co-primary safety endpoint of major adverse cardiovascular events was met in 6.2%,co-primary safety endpoint of bleeding in 7.8%and primary efficacy endpoint of TKLR in 1.5%.The multivariable adjusted model showed no significant association of the prescribed short/long dual antiplatelet therapy(DAPT)durations with any endpoint suggesting a well tailored therapy.No stent thrombosis reported in the subgroup with 1-3 months DAPT duration.As compared to control group,bleeding BARC 2-5 was significantly lower in SIERRA-75 group(7.4%vs.10.2%,P=0.04)as well as the net safety-efficacy endpoint(14.3%vs.18.5%,P=0.02).CONCLUSIONS In elderly population,the application of this risks-adjusted antithrombotic protocol after revascularization with last generation EES seems to be associated with an improved prognosis in terms of ischemic and bleeding outcomes.

关键词： patients bleeding antithrombotic

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Therapeutic Compliance of Hypertensive Patients Followed in Ambulatory in the cardiology department of Kati University Hospital

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World Journal of Cardiovascular Diseases 2024年第5期14卷 333-342页

作者： Boubacar Sonfo Coumba Thiam Mariam Sako Massama Konaté Youssouf Camara Mamadou Touré Boubacar Diarra Diakaridja Sacko Samba Sidibé Bassan Diarra Hamidou Camara Asmaou Keita Konimba Diarra Hamidou Oumar Bâ Ibrahima Sangaré Youssouf Guindo Sanoussi Daffe Daouda Fofana Souleymane Coulibaly Ichaka Menta department of cardiology University Hospital Bocar Sidy Sall Kati Mali department of cardiology University Hospital of Point G Bamako Mali department of cardiology Mali Hospital Bamako Mali department of cardiology University Hospital Mother-Child Luxembourg Bamako Mali department of cardiology University Hospital Gabriel Tour&#233 Bamako Mali department of cardiology Kayes Hospital Kayes Mali

Introduction: High blood pressure is a major public health problem worldwide due to its frequency and cardiovascular complications. Adherence to treatment for chronic diseases is a global problem. The aim was to study therapeutic adherence in hypertensive patients followed in ambulatory. Materials and Methods: This was a cross-sectional, descriptive study with prospective recruitment that took place from July 1 to December 31, 2022 (6 months) in the cardiology department of the university hospital of Kati. The variables studied were sociodemographic data, cardiovascular risk factors, comorbidities, the possession of insurance and compliance (the Girerd questionnaire was used to assess adherence). Results: A total of 1182 patients were consulted, including 887 for hypertension, a frequency of 75%. Fifty-six patients were included in the study. The average age was 58.18 ± 13.25 years with extremes of 30 and 80 years. There was a female predominance (75%) with a sex ratio of 0.3. The majority of patients lived in urban areas (89.3%). Out-of-school patients accounted for 44.6%, more than half of patients or 55.4% had no income, patients with medical coverage accounted for 67.9% of cases. The main risk factors were physical inactivity (25%) followed by smoking 14.3%. More than 71% of patients had a compliance problem and the main reasons were forgetting to take the drug with 73.2%, followed by delayed treatment of 50% and drug discontinuation of 28.6%. Conclusion: Compliance is a real challenge and a major public health issue. This study allowed us to find a real problem of compliance in our hypertensive patients. There was a statistically significant relationship between drug adherence and forgetting to take the drug and drug discontinuation.

关键词： Hypertensive Therapeutic Adherence University Hospital of Kati

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Epidemio-Clinical, Therapeutic and Evolutive Aspects of Aortic Dissection in the cardiology department in Poin “G” Hospital University Center Bamako

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World Journal of Cardiovascular Diseases 2018年第8期8卷 424-430页

作者： Samba Sidibé Coumba Adiaratou Thiam Abdoul Karim Sacko Mamadou Diakite Mariam Dagnoko Souleymane Coulibaly Nouhoum Diallo Hamidou Omar Ba Ibrahima Sangaré Somnoma Jean-Baptiste Tougouma Massama Konaté Oumar Daouda Koné Mamadou Touré Mariam Sako Ichaka Menta Illo Bela Diall Boubakar Diallo cardiology department Point “G” Hospital University Center Bamako Mali cardiology department Hospital Kati Bamako Mali cardiology department Gabriel TOURE Hospital University Center Bamako Mali Higher Institute of Health Sciences Nazi Boni de Bobo Dioulasso University Bobo Dioulasso Burkina Faso cardiology department Hospital Mali Bamako Mali Medical department of Institute for Studies and Research Bamako Mali

Objective: The work aimed at describing an epidemioclinical, therapeutic and evolutionary characteristics of patients hospitalized for aortic dissection in the cardiology department in Point “G” Hospital University Center in Bamako—Mali. Methodology: It was a descriptive cross-sectional study from January 2010 to February 2017 in the CHU Point G cardiology department, including all patients hospitalized during this period. Results: Of 6912 hospitalized patients, 23 patients were concerned by aortic dissection. The prevalence of aortic dissection was 0.33%. The most affected age group was 50 - 69 (43.5%) of patients. The predominance was male with a sex ratio of 4.75. The cardiovascular risk factors were high blood pressure (73.9%) and smoking (60.9%). The major functional signs were chest pain (65.2%) and dyspnea (65.2%). Asphygmy (56.5%) and breath of aortic insufficiency (60.9%) were the dominant physical signs. The electrocardiogram recorded sinus tachycardia with 86.9% of patients. The radiographic of the frontal thorax showed mediastina widening (73.9%). At echocardiography, dilatation of the ascending aorta was described with 73.9% and the intimal veil (47.8%). Pericardial effusion was observed with 26.1% of patients. In the thoracic angioscan, the aortic dissection gave 43.5% for type A and 56.5% for type B. The aneurysm of the aorta was abdominal with 21.7%, ascending portion (13.0%) and descending with 8.7%. Complications were dominated by heart failure (47.8%) and aneurysm of the aorta (34.8%). The lethality was 52.2%. Conclusion: Aortic dissection is a medical and surgical emergency with poor prediction.

关键词： Aortic Dissection cardiology Point G Hospital

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Effectiveness and safety of Shexiang Baoxin Pill(MUSKARDIA)in patients with stable coronary artery disease and concomitant diabetes mellitus:a subgroup analysis of a randomized clinical trial

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Chinese Medical Journal 2023年第1期136卷 82-87页

作者： Jingmin Zhou Haiming Shi Fusui Ji Yang Wu Yulan Zhao Jun Qian Junbo Ge department of cardiology Zhongshan HospitalFudan UniversityShanghai 200032China department of cardiology Huashan HospitalFudan UniversityShanghai 200040China department of cardiology Beijing HospitalBeijing 100005China department of cardiology Dongfang Hospital Affiliated to Beijing University of Chinese MedicineBeijing 100078China department of cardiology The Second Affiliated Hospital of Zhengzhou UniversityZhengzhouHenan 450014China department of cardiology The Center Hospital of Ma’anshanMa’anshanAnhui 243099China

Background:Preliminary studies have indicated that Shexiang Baoxin Pill(MUSKARDIA)has a coronary artery dilation effect and increases the coronary blood flow,relieving the symptoms of angina.This study aimed to evaluate the benefit of MUSKARDIA on patients with stable coronary artery disease(CAD)and diabetes mellitus(DM).Methods:This was a subgroup analysis of a multicenter,randomized,placebo-controlled phase IV trial.CAD patients with a medical history of DM or baseline fasting blood glucose(FBG)≥7.0 mmol/L were grouped according to the treatment(standard therapy plus MUSKARDIA or placebo).The primary outcome was major adverse cardiovascular events(MACEs),which was the composite outcome of cardiovascular death,non-fatal myocardial infarction,and non-fatal stroke.The secondary outcome was the composite outcome of all-cause death,non-fatal myocardial infarction,non-fatal stroke,hospitalization for unstable angina or heart failure,and coronary angioplasty.Results:MACEs occurred in 2.6%(9/340)and 4.8%(18/376)of patients in the MUSKARDIA and placebo groups,respectively(P=0.192).Secondary composite outcome was significantly less frequent with MUSKARDIA than with placebo(15.3%[52/340]vs.22.6%[85/376],P=0.017).Risk of MACEs(hazard ratio[HR]=0.69,95%confidence interval[CI]:0.31-1.57)was comparable between two groups.In patients with uncontrolled DM(≥4 measurements of FBG≥7 mmol/L in five times of follow-up),the risk of secondary outcome was significantly lower with MUSKARDIA(5/83,6.0%)than with placebo(15/91,16.5%)(HR=0.35,95%CI:0.13-0.95).Conclusion:As an add-on to standard therapy,MUSKARDIA shows a trend of reduced MACEs in patients with stable CAD and DM.Furthermore,MUSKARDIA may reduce the frequency of all-cause death,hospitalization,and coronary angioplasty in this population,especially in those with uncontrolled DM.Trial Registration:***,ChiCTR-TRC-12003513.

关键词： Shexiang Baoxin Pill MUSKARDIA Coronary artery disease Angina Diabetes mellitus Major adverse cardiovascular events

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Implantable cardiac defibrillators in octogenarians

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Journal of Geriatric cardiology 2023年第1期20卷 23-31页

作者： Maarten Pauwelyn Sebastian Ingelaere Ruben Hoffmann Johan Vijgen Georges H.Mairesse Ivan Blankoff Yves Vandekerckhove Jean-Benoit le Polain de Waroux Bert Vandenberk Rik Willems University Hospitals Leuven CardiologyLeuvenBelgium KU Leuven Department of Cardiovascular SciencesLeuvenBelgium UZA Department of CardiologyAntwerpBelgium Jessa Ziekenhuis Department of CardiologyHasseltBelgium Cliniques du Sud Luxembourg Department of CardiologyArlonBelgium CHU Charleroi Department of CardiologyCharleroiBelgium AZ Sint-Jan Department of CardiologyBruggeBelgium University of Calgary Libin Cardiovascular InstituteCalgaryCanada

OBJECTIVE Implantable cardiac defibrillators(ICD)implantation in the very elderly remains controversial.We aimed to describe the experience and outcome of patients over 80 years old implanted with an ICD in Belgium.METHODS Data were extracted from the national QERMID-ICD registry.All implantations performed in octogenarians between February 2010 and March 2019 were analysed.Data on baseline patient characteristics,type of prevention,device configuration and all-cause mortality were available.To determine predictors of mortality,multivariable Cox proportional hazard regression modelling was performed.RESULTS Nationwide,704 primo ICD implantations were performed in octogenarians(median age 82,IQR 81-83 years;83% male and 45% secondary prevention).During a mean follow-up of 3.1±2.3 years,249(35%)patients died,of which 76(11%)within the first year after implantation.In multivariable Cox regression analysis age(HR=1.15,P=0.004),oncological history(HR=2.43,P=0.027)and secondary prevention(HR=2.23,P=0.001)were independently associated with 1-year mortality.A better preserved left ventricular ejection fraction(LVEF)was associated with a better outcome(HR=0.97,P=0.002).Regarding overall mortality multivariable analysis withheld age,history of atrial fibrillation,centre volume and oncological history as significant predictors.Higher LVEF was again protective(HR=0.99,P=0.008).CONCLUSIONS Primary ICD implantation in octogenarians is not often performed in Belgium.Among this population,11%died within the first year after ICD implantation.Advanced age,oncological history,secondary prevention and a lower LVEF were associated with an increased one-year mortality.Age,low LVEF,atrial fibrillation,centre volume and oncological history were indicative of higher overall mortality.

关键词： prevention implantation protective

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Effects of Compound Danshen Dripping Pills on Ventricular Remodeling and Cardiac Function after Acute Anterior Wall ST-Segment Elevation Myocardial Infarction(CODE-AAMI):Protocol for a Randomized Placebo-Controlled Trial

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Chinese Journal of Integrative Medicine 2023年第12期29卷 1059-1065页

作者： WU Yu-jie DENG Bo WANG Si-bo QIAO Rui ZHANG Xi-wen LU Yuan WANG Li GU Shun-zhong ZHANG Yu-qing LI Kai-qiao YU Zong-liang WU Li-xing ZHAO Sheng-biao ZHOU Shuang-lin YANG Yang WANG Lian-sheng department of cardiology the First Affiliated Hospital of Nanjing Medical UniversityNanjing(210029)China department of cardiology Anqing Municipal Hospital Affiliated to Anhui Medical UniversityAnqingJiangsu Province(246003)China department of cardiology Huai'an First People's HospitalHuai'anJiangsu Province(223300)China department of cardiology the Affiliated Hospital of Xuzhou Medical UniversityXuzhouJiangsu Province(221006)China department of cardiology Pukou Branch of Jiangsu People's HospitalNanjing(211899)China department of cardiology Hai'an People's HospitalNantongJiangsu Province(226699)China department of cardiology the Affliated Jiangning Hospital of Nanjing Medical UniversityNanjing(211199)China department of cardiology Qixia District Hospital of Nanjing CityNanjing(210046)China department of cardiology the First People's Hospital of Kunshan Affliated to Jiangsu UniversityKunshanJiangsu Province(215300)China department of cardiology Nanjing Lishui District Hospital of Traditional Chinese MedicineNanjing(211299)China department of cardiology Nanjing Meishan HospitalNanjing(210039)China

Background:Ventricular remodeling after acute anterior wall ST-segment elevation myocardial infarction(AAMI)is an important factor in occurrence of heart failure which additionally results in poor prognosis.Therefore,the treatment of ventricular remodeling needs to be further optimized.Compound Danshen Dripping Pills(CDDP),a traditional Chinese medicine,exerts a protective effect on microcirculatory disturbance caused by ischemia-reperfusion injury and attenuates ventricular remodeling after myocardial infarction.Objective:This study is designed to evaluate the efficacy and safety of CDDP in improving ventricular remodeling and cardiac function after AAMI on a larger scale.Methods:This study is a multi-center,randomized,doubleblind,placebo-controlled,parallel-group clinical trial.The total of 268 patients with AAMI after primary percutaneous coronary intervention(pPCI)will be randomly assigned 1:1 to the CDDP group(n=134)and control group(n=134)with a follow-up of 48 weeks.Both groups will be treated with standard therapy of ST-segment elevation myocardial infarction(STEMI),with the CDDP group administrating 20 tablets of CDDP before pPCI and 10 tablets 3 times daily after pPCI,and the control group treated with a placebo simultaneously.The primary endpoint is 48-week echocardiographic outcomes including left ventricular ejection fraction(LVEF),left ventricular end-diastolic volume index(LVEDVI),and left ventricular end-systolic volume index(LVESVI).The secondary endpoint includes the change in N terminal pro-B-type natriuretic peptide(NT-proBNP)level,arrhythmias,and cardiovascular events(death,cardiac arrest,or cardiopulmonary resuscitation,rehospitalization due to heart failure or angina pectoris,deterioration of cardiac function,and stroke).Investigators and patients are both blinded to the allocated treatment.Discussion:This prospective study will investigate the efficacy and safety of CDDP in improving ventricular remodeling and cardiac function in patients undergoing pPCI for a first AAMI.Patients in the CD

关键词： Compound Danshen Dripping Pills acute anterior myocardial infarction randomized controlled trial ventricular remodeling cardiac function trial design

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End-of-life care in a cardiology department： have we improved？

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Journal of Geriatric cardiology 2016年第7期13卷 587-592页

作者： Juan Rulz-Garcia Pablo Dlez-Villanueva Ana Ayesta Vanessa Brufia Lourdes M Figueiras-Graillet Laura Gallego-Parra Francisco Fernandez-Aviles Manuel Martinez-Selles department of cardiology Hospital General Universitario Gregorio Maranon Calle Doctor Esquerdo Madrid Spain department of cardiology Hospital Universitario de Torrejon Calle Mateo Inurria Torrejon de Ardoz Madrid Spain Universidad Francisco de Vitoria Carretera Pozuelo a Majadahonda Pozuelo de Alareon Madrid Spain department of cardiology Hospital Universitario de la Princesa Calle de Diego de Leon Madrid Spain Departmet of cardiology Hospital Universitario del Sureste Ronda del Sur Arganda del Rey Madrid Spain Universidad Complutense de Madrid Av. Seneca Madrid Spain Universidad Europea de Madrid Urbanizacion E1Bosque Calle Tajo Villaviciosa de Odon Madrid Spain

BackgroundEnd-of-life 照顾不通常是在心病学部门的优先级。我们寻求了在 do-not-resuscitate (DNR ) 的介绍以后在 end-of-life 照顾评估变化顺序 protocol.Methods &；在在二经期的一个心病学部门的所有死亡的 ResultsRetrosp... 详细信息

BackgroundEnd-of-life 照顾不通常是在心病学部门的优先级。我们寻求了在 do-not-resuscitate (DNR ) 的介绍以后在 end-of-life 照顾评估变化顺序 protocol.Methods &；在在二经期的一个心病学部门的所有死亡的 ResultsRetrospective 分析，在协议的介绍前后。人口统计的特征， DNR 订单的使用，和 end-of-life 照顾的比较在两个时期之间发出，根据在表(组 A ) ，一份常规 DNR 订单(组 B ) 或任何 DNR 的缺席订的新 DNR 的第二经期(组 C ) 的存在。死亡的数字在两个时期是类似的(n = 198 对 n = 197 ) 。与一份 DNR 订单死的病人的率显著地增加了(57.1% 对 68.5% ；P = 0.02 ) 。仅仅在两个时期的 4% 病人知道关于心肺的复活作的决定。在组 A 的病人更早收到了 DNR 顺序一天，并且 24.5% 在录取的开始的 24 h 以内收到了它(对 2.6% 在第一个时期；P <；0.001 ) 。在有一个可植入的 cardioverter 使用高压脉冲来消减心脏(ICD ) 的组 A 的所有病人把电震疗法撤销(对 25.0% 在第一个时期；P = 0.02 ) 一个 DNR 顺序协议的 .ConclusionsThe 介绍可以由增加使用并且弄短在心脏病患者改进 end-of-life 照顾 DNR 订单的登记的时间。它可以也在地方与这些订单在病人贡献增加 ICD 释放。然而，在疾病的迟了的阶段的表的介绍没能改进耐心的参予。

关键词：心脏病患者护理生命 DNR 死亡人数统计特征心肺复苏 ICD

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