RESUMEN
OBJECTIVE: The European Society of Cardiology (ESC) 0/1-h Algorithm with high-sensitivity cardiac troponin T (hs-cTnT) has shown promising results in risk stratification and management of patients with coronary artery disease (CAD). However, its outcomes and clinical implications in the context of developing countries remain understudied. METHODS: This cohort study aimed to evaluate the outcomes and clinical significance of the ESC 0/1-h Algorithm in a developing country setting. A total of 3534 patients with CAD were enrolled, with 1125 in the Rule-Out group and 2409 in the Rule-In group. Baseline characteristics, performance metrics, primary and secondary outcomes, and predictors of Rule-In and Rule-Out groups were assessed. RESULTS: The study enrolled 3534 patients with CAD, with 1125 in the Rule-Out group and 2409 in the Rule-In group. The 0/1-h Algorithm with hs-cTnT demonstrated improved performance compared to Troponin T at Presentation. It exhibited higher sensitivity, specificity, negative predictive value, positive predictive value, and area under the curve (AUC) for risk stratification in patients with CAD. Significant differences were observed in baseline characteristics between the Rule-Out and Rule-In groups, including age, gender, and comorbidities. The Rule-In group had a higher incidence of adverse cardiac events and underwent more invasive procedures compared to the Rule-Out group. Age, gender, hypertension, diabetes, and smoking were identified as significant predictors of Rule-In and Rule-Out. These findings highlight the clinical significance of implementing the 0/1-h Algorithm in the management of patients with CAD in a developing country setting. CONCLUSION: The algorithm's performance, along with its ability to identify high-risk patients and predict outcomes, highlights its potential to enhance patient care and outcomes in resource-limited settings.
Asunto(s)
Cardiología , Enfermedad de la Arteria Coronaria , Infarto del Miocardio , Humanos , Troponina T , Enfermedad de la Arteria Coronaria/diagnóstico por imagen , Enfermedad de la Arteria Coronaria/terapia , Infarto del Miocardio/epidemiología , Estudios de Cohortes , Biomarcadores , Estudios Prospectivos , Resultado del Tratamiento , AlgoritmosRESUMEN
Anxiety and depression are commonly experienced by individuals with heart conditions, significantly impacting their overall well-being and prognosis. This review aims to provide an updated examination of the relationship between anxiety, depression, and heart disease. The review begins by exploring the prevalence of anxiety and depression in heart patients, highlighting the substantial rates at which these mental health disorders co-occur in this population. It further elucidates the risk factors that contribute to the development and exacerbation of anxiety and depression in individuals with heart conditions, including biological, psychological, and social factors. The impact of anxiety and depression on cardiac outcomes is a central focus of this review. It explores the intricate bi-directional relationship between mental health and cardiovascular health, discussing the mechanisms through which anxiety and depression can lead to adverse cardiac events and worsen existing heart conditions. Additionally, it examines the potential impact of anxiety and depression on treatment adherence, lifestyle modifications, and overall quality of life in heart patients. The review also investigates the diagnostic and assessment methods for anxiety and depression in heart patients, emphasizing the importance of implementing comprehensive screening protocols in clinical settings. In conclusion, this updated review provides valuable insights into the prevalence, impact, assessment, and management of anxiety and depression in heart patients. It underscores the importance of recognizing and addressing these mental health disorders within the context of cardiac care, ultimately aiming to enhance the overall well-being and prognosis of individuals living with heart conditions.