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Cardiovascular and oncological diseases are the main causes of death worldwide. Cancer patients have an increased risk of cardiovascular diseases but, at the same time cardiovascular patients experience a higher risk of cancer. This relationship goes beyond the toxicity concerning cancer treatment. Cardio-oncology goal is to facilitate cancer therapy by implementing preventive strategies that allow early diagnosis and treatment of potential cancer therapy-induced cardiovascular complications, being heart failure the most fearest one. The creation of Cardio-oncology services has the potential to impact daily clinical practice and public health, with clear implications for the future.

Objective. The purpose of this study is to determine the prognostic value of the absolute decrease in the N-terminal portion of pro-B-type natriuretic peptide (NT-proBNP) to prevent fewer clinical events, in the population of CLUSTER-HF (efficacy of ultrasound lung to guide therapy and prevent readmissions in heart failure). Materials and methods. This study was conducted in a subgroup of ninety-four patients with available NT-proBNP information at hospital discharge and prior to randomization in the CLUSTER-HF study. The primary objective of the study was to determine the prognostic value of absolute NT-proBNP decline below which fewer events of all-cause death, emergency room visits, and rehospitalization for heart failure at 180 days. Results. The absolute decrease in NT-proBNP below 3,350 pg/mL has a moderate discriminative capacity with AUC= 0.602, with a prognostic value in the com...

Objective. To determine the clinical factors associated to no-reflow after percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction (STEMI) in Peru. Materials and methods. Case - control retrospective study, derived from the PERSTEMI (Peruvian Registry of ST-elevation myocardial infarction) I and II study. Cases (group 1) were those patients who presented no-reflow after PCI, defined by a TIMI flow < 3, and controls (group 2) were those with a TIMI 3 flow after the intervention. Clinical and angiographic variables were compared between both groups, and a multivariate analysis was performed looking for associated factors to no-reflow. Results. We included 75 cases and 304 controls. The incidence of no-reflow was 19.8%. There was a higher frequency of no-reflow in patients with primary PCI compared to the pharmacoinvasive strategy, in patients...

Objetivo. Determinar las variables clínicas asociados a no reflujo tras la intervención coronaria percutánea (ICP) en pacientes con infarto de miocardio con elevación del segmento ST (IAMCEST) en el Perú. Materiales y métodos. Estudio de casos y controles retrospectivo, derivado de los registros PERSTEMI (registro peruano de infarto de miocardio con elevación del segmento ST) I y II. Se consideró casos (grupo 1) a los pacientes que presentaron no reflujo tras la ICP, definido porun flujo TIMI<3, y controles (grupo2) a aquellos con un flujoTIMI 3 post intervención. Se compararon variables clínicas y angiográficas entre ambos grupos y se realizó un análisis multivariable buscando variables independientes asociados a no reflujo. Resultados. Se incluyeron 75 casos y 304 controles. La incidencia de no reflujo fue del 19,8%. Se presentó mayor frecuencia de no refluj...

En diciembre de 2019, el síndrome respiratorio agudo severo, coronavirus 2 (SARS-CoV-2) causó un brote de neumonía (COVID-19) que ha llevado a un estado de pandemia hasta la actualidad (1). Esto ha generado cambios en todos los aspectos de nuestra vida, y pese a que las muertes por esta pandemia ascienden los 1,7 millones de personas para el año 2020 (2), debemos recordar que las muertes por causa cardiovascular (CV) ascienden a 17,9 millones de casos cada año (3), siendo esta otra pandemia desatendida principalmente en países de mediano y bajos ingreso, como el nuestro (3, 4).En vista de lo anterior, y pese a las barreras existentes, los avances científicos se continuaron dando y fueron presentados por vía virtual en las reuniones científicas más importantes a nivel mundial. A continuación, resaltamos aquellos que consideramos cambiarán las guías de práctica clínica sobre...

Objetivo. Determinar el valor pronóstico del descenso absoluto de la porción N-terminal del propéptido natriurético tipo B (NT–proBNP) para prevenir menos eventos clínicos en la población del estudio CLUSTER-HF (eficacia del ultrasonido pulmonar para guiar la terapia y prevenir las rehospitalizaciones en insuficiencia cardiaca). Materiales y métodos. El presente estudio fue realizado en un subgrupo de 94 pacientes con información disponible de NT-proBNP al alta hospitalaria y previo a la aleatorización del estudio CLUSTER-HF. El objetivo primario del estudio fue determinar el valor pronóstico de descenso absoluto de NT - pro-BNP por debajo del cual se prediga menos eventos de muerte por todas las causas, visitas a urgencias y rehospitalización por insuficiencia cardiaca a 180 días. Resultados. El descenso absoluto de NT-proBNP por debajo de 3 350 pg/mL tiene una capacidad d...

Cardiovascular and oncological diseases are the main causes of death worldwide. Cancer patients have an increased risk of cardiovascular diseases but, at the same time cardiovascular patients experience a higher risk of cancer. This relationship goes beyond the toxicity concerning cancer treatment. Cardio-oncology goal is to facilitate cancer therapy by implementing preventive strategies that allow early diagnosis and treatment of potential cancer therapy-induced cardiovascular complications, being heart failure the most fearest one. The creation of Cardio-oncology services has the potential to impact daily clinical practice and public health, with clear implications for the future.

Objective. The purpose of this study is to determine the prognostic value of the absolute decrease in the N-terminal portion of pro-B-type natriuretic peptide (NT-proBNP) to prevent fewer clinical events, in the population of CLUSTER-HF (efficacy of ultrasound lung to guide therapy and prevent readmissions in heart failure). Materials and methods. This study was conducted in a subgroup of ninety-four patients with available NT-proBNP information at hospital discharge and prior to randomization in the CLUSTER-HF study. The primary objective of the study was to determine the prognostic value of absolute NT-proBNP decline below which fewer events of all-cause death, emergency room visits, and rehospitalization for heart failure at 180 days. Results. The absolute decrease in NT-proBNP below 3,350 pg/mL has a moderate discriminative capacity with AUC= 0.602, with a prognostic value in the com...

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Objective. To determine the clinical factors associated to no-reflow after percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction (STEMI) in Peru. Materials and methods. Case - control retrospective study, derived from the PERSTEMI (Peruvian Registry of ST-elevation myocardial infarction) I and II study. Cases (group 1) were those patients who presented no-reflow after PCI, defined by a TIMI flow < 3, and controls (group 2) were those with a TIMI 3 flow after the intervention. Clinical and angiographic variables were compared between both groups, and a multivariate analysis was performed looking for associated factors to no-reflow. Results. We included 75 cases and 304 controls. The incidence of no-reflow was 19.8%. There was a higher frequency of no-reflow in patients with primary PCI compared to the pharmacoinvasive strategy, in patients...

Tomando en cuenta nuestras altas cifras de morbimortalidad por esta patología a nivel nacional superiores a las de otros países de la región, sugerimos que nuestras autoridades y gestores de salud sigan desarrollando estrategias a nivel nacional para mejorar el proceso de atención del infarto de miocardio con elevación del segmento ST, implementando un sistema de redes para la atención del infarto, fortaleciendo la estrategia farmacoinvasiva oportuna en centros periféricos sin capacidad de ICP, y mejorando la capacidad de ICP primaria en los principales hospitales de nuestro país.

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ST-segment elevation myocardial infarction (STEMI) is a clinical entity whose adequate treatment will depend on its prompt recognition, accurate diagnosis, and management in reperfusion networks. The first contact with these patients is generally done in centers without reperfusion capacity, attended by non-cardiologist doctors, and in centers far from hospitals with greater resolution capacity, something that is well known in our country. This manuscript proposes a strategy for the diagnosis and treatment of STEMI in centers without percutaneous coronary intervention capacity of the public health system in Peru, emphasizing not losing sight of electrocardiographic patterns compatible with coronary artery occlusion, adequate fibrinolysis and management of its complications, the treatment of infarction in special populations and highlighting the importance of the pharmacoinvasive strategy...

El infarto de miocardio con elevación del segmento ST (IMCEST) es una entidad clínica cuyo tratamiento adecuado dependerá de su pronto reconocimiento, diagnóstico certero y manejo en redes de reperfusión. El primer contacto con estos pacientes es generalmente en centros sin capacidad de reperfusión, atendidos por médicos no cardiólogos y en centros alejados de hospitales de mayor capacidad resolutiva, algo que es bien conocido en nuestro país. Este manuscrito propone la estrategia de diagnóstico y tratamiento del IMCEST para centros sin capacidad de intervención coronaria percutánea del sistema público de salud en el Perú, haciendo hincapié en no perder de vista patrones electrocardiográficos compatibles con oclusión de la arteria coronaria, fibrinolisis adecuada y manejo de sus complicaciones, el tratamiento del infarto en poblaciones especiales y resaltando la importan...

ST-segment elevation myocardial infarction (STEMI) is a clinical entity whose adequate treatment will depend on its prompt recognition, accurate diagnosis, and management in reperfusion networks. The first contact with these patients is generally done in centers without reperfusion capacity, attended by non-cardiologist doctors, and in centers far from hospitals with greater resolution capacity, something that is well known in our country. This manuscript proposes a strategy for the diagnosis and treatment of STEMI in centers without percutaneous coronary intervention capacity of the public health system in Peru, emphasizing not losing sight of electrocardiographic patterns compatible with coronary artery occlusion, adequate fibrinolysis and management of its complications, the treatment of infarction in special populations and highlighting the importance of the pharmacoinvasive strategy...