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| Format: | Artículo científico |
| Language: | en |
| Published: |
Sociedad Latinoamericana de Hipertensión
2019
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| Online Access: | https://www.redalyc.org/articulo.oa?id=170263176002 https://www.redalyc.org/journal/1702/170263176002/ https://www.redalyc.org/journal/1702/170263176002/html/ https://www.redalyc.org/journal/1702/170263176002/170263176002.epub https://www.redalyc.org/journal/1702/170263176002/movil |
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Table of Contents:
- Decision making in Ischemic cardiomyopathy: variability in physicians’ approaches and patients’ adherence Mostafa Bahremand Taha Ahmadinejad Yaser Jenab Seyed Kianoush Hoseini Masoumeh Lotfi-Tokaldany Arash Jalali Medicina cardiomyopathies patient adherence myocardial ischemia coronary artery bypass clinical decision making Ischemic cardiomyopathy (ICM) is a common cardiovascular disease with conflicting evidence regarding its management and a high risk profile for revascularization procedures that seems to have resulted in variable approach of physicians toward its management, and likewise, significant patient non-adherence to physician recommendation. We included patients with 3-vessel disease and left ventricular ejection fraction (LVEF) <45%(ICM group; n=825), and patients with LM disease and LVEF ≥45% (LM group; n=162), detected by coronary angiography at Tehran Heart Center. Variation of recommendations among cardiologists was evaluated. The rate of coronary artery bypass graft (CABG) non-adherence was also determined, as well as its predictors and outcome in ICM group. Decision making was more variable in ICM group, compared to LM group. CABG non-adherence was significantly more common in ICM group (32.4%), compared to LM group (10.0%) (P<0.001). Advanced age, being female, absence of angina, creatinine >2mg/dl, severe left ventricular dysfunction, absence of LM disease and moderate or severe mitral regurgitation were predictors of CABG non-adherence. ICM patients with CABG non-adherence had significantly more all-cause mortality (Hazard Ratio HR: 1.97, 95% confidence interval CI: 1.28-3.04), and more all-cause mortality, revascularization or hospitalization due to cardiac disease (HR: 1.94, 95% CI: 1.41-2.67), than those who received CABG. While ICM is a common disorder encountered frequently in daily practice of cardiologists, there is a significant variability in decision making, as well as a significant non-adherenceto lifesaving recommendations for these patients. 2019 artículo científico 1856-4550 https://www.redalyc.org/articulo.oa?id=170263176002 https://www.redalyc.org/journal/1702/170263176002/ https://www.redalyc.org/journal/1702/170263176002/html/ https://www.redalyc.org/journal/1702/170263176002/170263176002.epub https://www.redalyc.org/journal/1702/170263176002/movil en http://www.redalyc.org/revista.oa?id=1702 Revista Latinoamericana de Hipertensión application/pdf Sociedad Latinoamericana de Hipertensión Revista Latinoamericana de Hipertensión (República Bolivariana de Venezuela) Num.3 Vol.14