Factores asociados con revascularización miocárdica quirúrgica en pacientes con infarto agudo de miocardio: estudio de casos y controles en un hospital de alta complejidad de Bogotá, Colombia, entre 2014 y 2019

La enfermedad cardiovascular corresponde a la enfermedad crónica no transmisible con más prevalencia a nivel global, configurando una alta carga en salud. El tratamiento del infarto agudo de miocardio tiene sus pilares en el manejo médico y la terapia de reperfusión que puede ser percutánea o quirúr...

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Fecha de publicación:
2022
Institución:
Universidad del Rosario
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Repositorio EdocUR - U. Rosario
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spa
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oai:repository.urosario.edu.co:10336/34769
Acceso en línea:
https://doi.org/10.48713/10336_34769
https://repository.urosario.edu.co/handle/10336/34769
Palabra clave:
Enfermedad cardiovascular
Enfermedad crónica no transmisible
Tratamiento del infarto agudo de miocardio
Revascularización miocárdica quirúrgica
Enfermedades
Heart disease
Chronic non-communicable disease
Treatment of acute myocardial infarction
Surgical myocardial revascularization
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Atribución-NoComercial-CompartirIgual 2.5 Colombia
id EDOCUR2_bac1230460a973f86b29e30045521200
oai_identifier_str oai:repository.urosario.edu.co:10336/34769
network_acronym_str EDOCUR2
network_name_str Repositorio EdocUR - U. Rosario
repository_id_str
dc.title.es.fl_str_mv Factores asociados con revascularización miocárdica quirúrgica en pacientes con infarto agudo de miocardio: estudio de casos y controles en un hospital de alta complejidad de Bogotá, Colombia, entre 2014 y 2019
dc.title.TranslatedTitle.es.fl_str_mv Factors associated with surgical myocardial revascularization in patients with acute myocardial infarction: a case-control study in a high-complexity hospital in Bogotá, Colombia, between 2014 and 2019
title Factores asociados con revascularización miocárdica quirúrgica en pacientes con infarto agudo de miocardio: estudio de casos y controles en un hospital de alta complejidad de Bogotá, Colombia, entre 2014 y 2019
spellingShingle Factores asociados con revascularización miocárdica quirúrgica en pacientes con infarto agudo de miocardio: estudio de casos y controles en un hospital de alta complejidad de Bogotá, Colombia, entre 2014 y 2019
Enfermedad cardiovascular
Enfermedad crónica no transmisible
Tratamiento del infarto agudo de miocardio
Revascularización miocárdica quirúrgica
Enfermedades
Heart disease
Chronic non-communicable disease
Treatment of acute myocardial infarction
Surgical myocardial revascularization
title_short Factores asociados con revascularización miocárdica quirúrgica en pacientes con infarto agudo de miocardio: estudio de casos y controles en un hospital de alta complejidad de Bogotá, Colombia, entre 2014 y 2019
title_full Factores asociados con revascularización miocárdica quirúrgica en pacientes con infarto agudo de miocardio: estudio de casos y controles en un hospital de alta complejidad de Bogotá, Colombia, entre 2014 y 2019
title_fullStr Factores asociados con revascularización miocárdica quirúrgica en pacientes con infarto agudo de miocardio: estudio de casos y controles en un hospital de alta complejidad de Bogotá, Colombia, entre 2014 y 2019
title_full_unstemmed Factores asociados con revascularización miocárdica quirúrgica en pacientes con infarto agudo de miocardio: estudio de casos y controles en un hospital de alta complejidad de Bogotá, Colombia, entre 2014 y 2019
title_sort Factores asociados con revascularización miocárdica quirúrgica en pacientes con infarto agudo de miocardio: estudio de casos y controles en un hospital de alta complejidad de Bogotá, Colombia, entre 2014 y 2019
dc.contributor.advisor.none.fl_str_mv Ortiz Trujillo, Carlos Andrés
Molano González, Nicolás
dc.subject.es.fl_str_mv Enfermedad cardiovascular
Enfermedad crónica no transmisible
Tratamiento del infarto agudo de miocardio
Revascularización miocárdica quirúrgica
topic Enfermedad cardiovascular
Enfermedad crónica no transmisible
Tratamiento del infarto agudo de miocardio
Revascularización miocárdica quirúrgica
Enfermedades
Heart disease
Chronic non-communicable disease
Treatment of acute myocardial infarction
Surgical myocardial revascularization
dc.subject.ddc.es.fl_str_mv Enfermedades
dc.subject.keyword.es.fl_str_mv Heart disease
Chronic non-communicable disease
Treatment of acute myocardial infarction
Surgical myocardial revascularization
description La enfermedad cardiovascular corresponde a la enfermedad crónica no transmisible con más prevalencia a nivel global, configurando una alta carga en salud. El tratamiento del infarto agudo de miocardio tiene sus pilares en el manejo médico y la terapia de reperfusión que puede ser percutánea o quirúrgica (CABG). Una de las limitaciones que se presentan a la hora de realizar el CABG, es la necesidad de depurar los niveles de antiplaquetarios de tipo inhibidores de P2Y12 para disminuir el riesgo de sangrado perioperatorio(8). En las últimas décadas se han hecho algunos intentos por identificar factores que permitan identificar a los pacientes con alta probabilidad de tener enfermedad multivaso e indicación de CABG; sin embargo, los grupos evaluados han sido muy heterogéneos y no se ha logrado plantear estrategias que predigan con seguridad. Se realizará un estudio retrospectivo de casos y controles con pacientes adultos atendidos en la Fundación Cardioinfantil entre 2014 y 2019 con infarto agudo de miocardio para evaluar la relación entre factores clínicos y la revascularización miocárdica quirúrgica.
publishDate 2022
dc.date.accessioned.none.fl_str_mv 2022-08-24T02:23:38Z
dc.date.available.none.fl_str_mv 2022-08-24T02:23:38Z
dc.date.created.none.fl_str_mv 2022-07-19
dc.type.es.fl_str_mv bachelorThesis
dc.type.coar.fl_str_mv http://purl.org/coar/resource_type/c_7a1f
dc.type.document.es.fl_str_mv Trabajo de grado
dc.type.spa.es.fl_str_mv Trabajo de grado
dc.identifier.doi.none.fl_str_mv https://doi.org/10.48713/10336_34769
dc.identifier.uri.none.fl_str_mv https://repository.urosario.edu.co/handle/10336/34769
url https://doi.org/10.48713/10336_34769
https://repository.urosario.edu.co/handle/10336/34769
dc.language.iso.es.fl_str_mv spa
language spa
dc.rights.*.fl_str_mv Atribución-NoComercial-CompartirIgual 2.5 Colombia
dc.rights.coar.fl_str_mv http://purl.org/coar/access_right/c_abf2
dc.rights.acceso.es.fl_str_mv Abierto (Texto Completo)
rights_invalid_str_mv Atribución-NoComercial-CompartirIgual 2.5 Colombia
Abierto (Texto Completo)
http://purl.org/coar/access_right/c_abf2
dc.format.extent.es.fl_str_mv 82 pp
dc.format.mimetype.es.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Universidad del Rosario
dc.publisher.department.none.fl_str_mv Escuela de Medicina y Ciencias de la Salud
dc.publisher.program.none.fl_str_mv Especialización en Medicina Interna
publisher.none.fl_str_mv Universidad del Rosario
institution Universidad del Rosario
dc.source.bibliographicCitation.es.fl_str_mv Benjamin EJ, Muntner P, Alonso A, Bittencourt MS, Callaway CW, Carson AP, et al. Heart Disease and Stroke Statistics—2019 Update: A Report From the American Heart Association. Circulation. 2019 Mar 5;139(10):e56–528.
Roth GA, Johnson C, Abajobir A, Abd-Allah F, Abera SF, Abyu G, et al. Global, Regional, and National Burden of Cardiovascular Diseases for 10 Causes, 1990 to 2015. J Am Coll Cardiol. 2017 Jul;70(1):1–25.
Roth GA, Johnson CO, Abate KH, Abd-Allah F, Ahmed M, Alam K, et al. The Burden of Cardiovascular Diseases Among US States, 1990-2016. JAMA Cardiology. 2018 May 1;3(5):375.
Ibanez B, James S, Agewall S, Antunes MJ, Bucciarelli-Ducci C, Bueno H, et al. 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation. European Heart Journal. 2018 Jan 7;39(2):119–77.
Roffi M, Patrono C, Collet JP, Mueller C, Valgimigli M, Andreotti F, et al. 2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation. European Heart Journal. 2016 Jan 14;37(3):267–315.
Amsterdam EA, Wenger NK, Brindis RG, Casey DE, Ganiats TG, Holmes DR, et al. 2014 AHA/ACC Guideline for the Management of Patients With Non–ST-Elevation Acute Coronary Syndromes. J Am Coll Cardiol. 2014 Dec;64(24):e139–228
Layne K, Ferro A. Antiplatelet Therapy in Acute Coronary Syndrome. European cardiology review. 2016;69–76.
Neumann FJ, Sousa-Uva M, Ahlsson A, Alfonso F, Banning AP, Benedetto U, et al. 2018 ESC/EACTS Guidelines on myocardial revascularization. European Heart Journal. 2019 Jan 7;40(2):87–165.
Mehta RH, Chen AY, Pollack C V., Roe MT, Zalenski RJ, Clements EA, et al. Challenges in Predicting the Need for Coronary Artery Bypass Grafting at Presentation in Patients With Non–ST-Segment Elevation Acute Coronary Syndromes. The American Journal of Cardiology. 2006 Sep;98(5):624–7.
Shafiq A, Jang JS, Kureshi F, Fendler TJ, Gosch K, Jones PG, et al. Predicting Likelihood for Coronary Artery Bypass Grafting After Non–ST-Elevation Myocardial Infarction: Finding the Best Prediction Model. The Annals of Thoracic Surgery. 2016 Oct;102(4):1304–11.
Chew DP, Mahaffey KW, White HD, Huang Z, Hoekstra JW, Ferguson JJ, et al. Coronary artery bypass surgery in patients with acute coronary syndromes is difficult to predict. American Heart Journal. 2008 May;155(5):841–7.
Kaptoge S, Pennells L, De Bacquer D, Cooney MT, Kavousi M, Stevens G, et al. World Health Organization cardiovascular disease risk charts: revised models to estimate risk in 21 global regions. The Lancet Global Health. 2019 Oct;7(10):e1332–45
Fernández de Larrea-Baz N, Morant-Ginestar C, Catalá-López F, Gènova-Maleras R, Álvarez-Martín E. Disability-adjusted Life Years Lost to Ischemic Heart Disease in Spain. Revista Española de Cardiología (English Edition). 2015 Nov;68(11):968–75.
Vedanthan R, Seligman B, Fuster V. Global Perspective on Acute Coronary Syndrome. Circulation Research. 2014 Jun 6;114(12):1959–75.
Thygesen K, Alpert JS, Jaffe AS, Chaitman BR, Bax JJ, Morrow DA, et al. Fourth Universal Definition of Myocardial Infarction (2018). Circulation. 2018 Nov 13;138(20):e618–51.
Thuijs DJFM, Kappetein AP, Serruys PW, Mohr FW, Morice MC, Mack MJ, et al. Percutaneous coronary intervention versus coronary artery bypass grafting in patients with three-vessel or left main coronary artery disease: 10-year follow-up of the multicentre randomised controlled SYNTAX trial. The Lancet. 2019 Oct;394(10206):1325–34.
Garot P, Lefevre T. Treatment Selection for Multivessel Coronary Artery Disease. Cardiac Interventions Today. 2011;(January/February):54–9.
De Innocentiis C, Zimarino M, De Caterina R. Is complete revascularisation mandated for all patients with multivessel coronary artery disease? Interventional Cardiology Review. 2018;13(1):45–50.
Khan AR, Golwala H, Tripathi A, Riaz H, Kumar A, Flaherty MP, et al. Meta-analysis of Percutaneous Coronary Intervention Versus Coronary Artery Bypass Grafting in Left Main Coronary Artery Disease. The American Journal of Cardiology. 2017 Jun;119(12):1949– 56.
Head SJ, Milojevic M, Daemen J, Ahn JM, Boersma E, Christiansen EH, et al. Mortality after coronary artery bypass grafting versus percutaneous coronary intervention with stenting for coronary artery disease: a pooled analysis of individual patient data. The Lancet. 2018 Mar;391(10124):939–48
Lee CW, Ahn JM, Cavalcante R, Sotomi Y, Onuma Y, Suwannasom P, et al. Coronary Artery Bypass Surgery Versus Drug-Eluting Stent Implantation for Left Main or Multivessel Coronary Artery Disease. JACC: Cardiovascular Interventions. 2016 Dec;9(24):2481–9.
Desperak P, Hawranek M, Hrapkowicz T, Zembala MO, Gąsior M. Comparison of multivessel percutaneous coronary intervention and coronary artery bypass grafting in patients with severe coronary artery disease presenting with non-ST-segment elevation acute coronary syndromes. Kardiologia Polska. 2018 Jul 24;76(10):1474–81.
Bryer E, Stein E, Goldberg S. Multivessel Coronary Artery Disease. The Limitations of a “One-Size-Fits-All” Approach Emily. Mayo Clinic Proceedings: Innovations, Quality & Outcomes. 2020 Dec;4(6):638–41.
Garcia S, Canoniero MJ, Chirinos JA, de Marchena E, Salerno T, Ferreira A. Development of a Score to Predict the Need for Coronary Artery Bypass Graft Surgery in Patients With Non-ST Segment Elevation Acute Coronary Syndromes. The Annals of Thoracic Surgery. 2004 Dec;78(6):2022–6.
Bianco V, Kilic A, Gleason TG, Aranda-Michel E, Wang Y, Navid F, et al. Timing of coronary artery bypass grafting after acute myocardial infarction may not influence mortality and readmissions. The Journal of Thoracic and Cardiovascular Surgery. 2019 Dec;
Biancari F, Airaksinen KEJ, Lip GYH. Benefits and risks of using clopidogrel before coronary artery bypass surgery: Systematic review and meta-analysis of randomized trials and observational studies. The Journal of Thoracic and Cardiovascular Surgery. 2012 Mar;143(3):665-675.e4
Don CW, Roe MT, Li S, Fraulo E, Pomerantsev E, Palacios I, et al. Temporal trends and practice variations in clopidogrel loading doses in patients with non–ST-segment elevation myocardial infarction, from the National Cardiovascular Data Registry. American Heart Journal. 2011 Apr;161(4):689–97.
Burke MA, Lee R, Fintel DJ. Early clopidogrel use in non–ST elevation acute coronary syndrome and subsequent coronary artery bypass grafting. American Heart Journal. 2011 May;161(5):832–41.
Collet JP, Thiele H, Barbato E, Barthélémy O, Bauersachs J, Bhatt DL, et al. 2020 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation. European Heart Journal. 2020 Aug 29;1–79
Montalescot G, Bolognese L, Dudek D, Goldstein P, Hamm C, Tanguay JF, et al. Pretreatment with Prasugrel in Non–ST-Segment Elevation Acute Coronary Syndromes. New England Journal of Medicine. 2013 Sep 12;369(11):999–1010.
Dworeck C, Redfors B, Angerås O, Haraldsson I, Odenstedt J, Ioanes D, et al. Association of Pretreatment With P2Y12 Receptor Antagonists Preceding Percutaneous Coronary Intervention in Non-ST-Segment Elevation Acute Coronary Syndromes With Outcomes. JAMA Netw Open. 2020;3(10):e2018735
Schüpke S, Neumann FJ, Menichelli M, Mayer K, Bernlochner I, Wöhrle J, et al. Ticagrelor or Prasugrel in Patients with Acute Coronary Syndromes. New England Journal of Medicine. 2019;381(16):1524–34
Libby P, Theroux P. Pathophysiology of Coronary Artery Disease. Circulation. 2005 Jun 28;111(25):3481–8.
Crea F, Libby P. Acute coronary syndromes: The way forward from mechanisms to precision treatment. Circulation. 2017;136(12):1155–66.
Scholz KH, Maier SKG, Maier LS, Lengenfelder B, Jacobshagen C, Jung J, et al. Impact of treatment delay on mortality in ST-segment elevation myocardial infarction (STEMI) patients presenting with and without haemodynamic instability: Results from the German prospective, multicentre FITT-STEMI trial. European Heart Journal. 2018;39(13):1065–74
Dharma S. Comparison of Real-Life Systems of Care for ST-Segment Elevation Myocardial Infarction. Vol. 15, Global heart. 2020. p. 66.
Núñez Aragón R, Pedro-Botet Montoya ML, Mateu Pruñonosa L, Vallejo Camazón N, Sopena Galindo N, Casas García I, et al. Factores asociados y análisis descriptivo de la endocarditis infecciosa adquirida en el entorno hospitalario de un centro terciario de referencia. Enfermedades Infecciosas y Microbiología Clínica. 2013 Jan;31(1):15–22
Calé R, Pereira H, Pereira E, Vitorino S, de Mello S. Time to reperfusion in high-risk patients with myocardial infarction undergoing primary percutaneous coronary intervention. Revista Portuguesa de Cardiologia. 2019 Sep;38(9):637–46.
Dauerman HL, Gogo PB, Sobel BE. Reperfusion therapies for acute ST elevation myocardial infarction. In: Cardiac Intensive Care. Third Edit. Elsevier; 2018. p. 103- 116.e5.
Dávila FA, Pardo DA, Lewis AJ, Vargas L. Análisis de supervivencia según la oportunidad de atención en la enfermedad coronaria. Revista Colombiana de Cardiología. 2016 Sep;23(5):346–50.
Cano N. Epidemiología del infarto agudo del miocardio en el Hospital Santa Sofía de Manizales. Estudio descriptivo (junio de 2000 a junio de 2003). Rev colomb cardiol. 2004;11(3):157–63.
Méndez-Muñoz PC, Martínez-Espitia E, Paba-Rojas CE, Rodríguez-Perdomo J, SilvaHernández LM. Mortalidad por enfermedad isquémica cardiaca según variables sociodemográficas en Bogotá, Colombia. Revista Salud Bosque. 2020;10(1):65–78.
Boyle AJ. Predicting Left Main and Triple-vessel Disease in ACS. 2011.
Avci BK, Ikitimur B, Tok OO, Cimci M, Erturk E, Omar TB, et al. OP-079 The Role of GRACE Score in Prediction of High Risk Coronary Anatomy in Patients with Non-ST Elevation Acute Coronary Syndrome. The American Journal of Cardiology. 2015 Mar;115:S35.
Mota F Da, Azevedo P, Fernandes R, Guedes J, Bento D, Marques N, et al. Prediction of CABG indication in patients admitted for NSTEMI with the new CABG DAPE2S score. European Heart Journal ( 2016 ) 37 ( Abstract Supplement ), 572. 2019.
Bahall M, Legall G, Khan K. Quality of life among patients with cardiac disease: the impact of comorbid depression. Health and Quality of Life Outcomes. 2020 Dec 17;18(1):189
Ko H young, Lee J kwon, Shin J young, Jo E. Health-Related Quality of Life and Cardiovascular Disease Risk in Korean Adults. Korean Journal of Family Medicine. 2015;36(6):349.
Ram E, Sternik L, Klempfner R, Iakobishvili Z, Peled Y, Shlomo N, et al. Outcomes of different revascularization strategies among patients presenting with acute coronary syndromes without ST elevation. The Journal of Thoracic and Cardiovascular Surgery. 2019 Sep;
Qintar M, Humphries KH, Park JE, Arnold S V, Tang Y, Jones P, et al. Individualizing Revascularization Strategy for Diabetic Patients With Multivessel Coronary Disease. J Am Coll Cardiol. 2019 Oct;74(16):2074–84.
Qintar M, Humphries KH, Park JE, Arnold S V, Tang Y, Jones P, et al. Individualizing Revascularization Strategy for Diabetic Patients With Multivessel Coronary Disease. J Am Coll Cardiol. 2019 Oct;74(16):2074–84.
Ge J, Li J, Yu H, Hou B. Hypertension Is an Independent Predictor of Multivessel Coronary Artery Disease in Young Adults with Acute Coronary Syndrome. International Journal of Hypertension. 2018 Nov 13;2018:1–9.
José de Carvalho Cantarelli M, Castello HJ, Gonçalves R, Gioppato S, Batista de Freitas Guimarães J, Pracchia Ribeiro EK, et al. Independent predictors of multivessel coronary artery disease: results from Angiocardio Registry. Revista Brasileira de Cardiologia Invasiva (English Edition). 2015 Oct;23(4):266–70
Warrington KJ, Kent PD, Frye RL, Lymp JF, Kopecky SL, Goronzy JJ, et al. Rheumatoid arthritis is an independent risk factor for multi-vessel coronary artery disease: a case control study. Arthritis Res Ther. 2005;7(5):R984-91
Kosuge M, Ebina T, Hibi K, Morita S, Endo M, Maejima N, et al. An Early and Simple Predictor of Severe Left Main and/or Three-Vessel Disease in Patients With Non–STSegment Elevation Acute Coronary Syndrome. The American Journal of Cardiology. 2011 Feb;107(4):495–500
Fu X, Wilson P, Chung WSF. Time-to-reperfusion in patients with acute myocardial infarction and mortality in prehospital emergency care: meta-analysis. BMC Emergency Medicine. 2020 Dec 26;20(1):65.
Woodward M. Epidemiology Study Design and Data Analysis. Chapman & Hall/CRC, editor. New York; 2005. 381-426. p
Team RC. R: A language and environment for statistical computing. Vienna, Austria: R Foundation for Statistical Computing; 2020
Mahmood SS, Levy D, Vasan RS, Wang TJ. The Framingham Heart Study and the epidemiology of cardiovascular disease: a historical perspective. The Lancet. 2014 Mar;383(9921):999–1008
Sarmiento Agamez OD. Registro colombiano de pacientes con Síndrome Coronario Agudo Cohorte Fundación Clínica Shaio . [Bogotá]: Fundación Clínica Shaio; 2022.
Chavarriaga JC. Características epidemiológicas, clínicas, tratamiento y pronóstico de los pacientes con diagnóstico de síndrome coronario agudo en unidad especializada. Acta Medica Colombiana. 2014;39(1).
Lanas F, Avezum A, Bautista LE, Diaz R, Luna M, Islam S, et al. Risk Factors for Acute Myocardial Infarction in Latin America. Circulation. 2007 Mar 6;115(9):1067–74.
García A JCMPAJAAMCRMLGMJTA. Registro Mexicano de Síndromes Coronarios Agudos. Archivos de cardiología de México. 2005;75(1).
Rogers WJ, Frederick PD, Stoehr E, Canto JG, Ornato JP, Gibson CM, et al. Trends in presenting characteristics and hospital mortality among patients with ST elevation and nonST elevation myocardial infarction in the National Registry of Myocardial Infarction from 1990 to 2006. American Heart Journal. 2008 Dec;156(6):1026–34.
Bainey KR, Welsh RC, Alemayehu W, Westerhout CM, Traboulsi D, Anderson T, et al. Population-level incidence and outcomes of myocardial infarction with non-obstructive coronary arteries (MINOCA): Insights from the Alberta contemporary acute coronary syndrome patients invasive treatment strategies (COAPT) study. International Journal of Cardiology. 2018 Aug;264:12–7.
Pasupathy S, Air T, Dreyer RP, Tavella R, Beltrame JF. Systematic Review of Patients Presenting With Suspected Myocardial Infarction and Nonobstructive Coronary Arteries. Circulation. 2015 Mar 10;131(10):861–70.
Mehta SR, Bossard M. Acute Coronary Syndromes and Multivessel Disease. JACC: Cardiovascular Interventions. 2020 Jul;13(13):1568–70.
Tarantini G, Mojoli M, Varbella F, Caporale R, Rigattieri S, Andò G, et al. Timing of Oral P2Y12 Inhibitor Administration in Patients With Non-ST-Segment Elevation Acute Coronary Syndrome. J Am Coll Cardiol. 2020 Nov;76(21):2450–9.
García AM. Infarto agudo de miocardio con supradesnivel persistente del segmento ST: Registro multicéntrico SCAR (Síndromes Coronarios Agudos en Argentina) de la Sociedad Argentina de Cardiología. Rev argent cardiol. 2014;82(4)
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spelling Ortiz Trujillo, Carlos Andrés876e5125-f593-4ab5-8ce7-61bf3d4f83b8600Molano González, Nicolás80873475600Castellanos Alfonso, David EnriqueCruz Cuevas, José DavidAriza Ordóñez, NicolásEspecialista en Medicina InternaMaestríaFull time112d0716-e3f9-4c13-9b12-9111eb3be761600aaa44e46-f4a1-46c6-9715-84d6d13d70c6600542c0e14-7b02-4955-8e6b-eeb2828ca7e16002022-08-24T02:23:38Z2022-08-24T02:23:38Z2022-07-19La enfermedad cardiovascular corresponde a la enfermedad crónica no transmisible con más prevalencia a nivel global, configurando una alta carga en salud. El tratamiento del infarto agudo de miocardio tiene sus pilares en el manejo médico y la terapia de reperfusión que puede ser percutánea o quirúrgica (CABG). Una de las limitaciones que se presentan a la hora de realizar el CABG, es la necesidad de depurar los niveles de antiplaquetarios de tipo inhibidores de P2Y12 para disminuir el riesgo de sangrado perioperatorio(8). En las últimas décadas se han hecho algunos intentos por identificar factores que permitan identificar a los pacientes con alta probabilidad de tener enfermedad multivaso e indicación de CABG; sin embargo, los grupos evaluados han sido muy heterogéneos y no se ha logrado plantear estrategias que predigan con seguridad. Se realizará un estudio retrospectivo de casos y controles con pacientes adultos atendidos en la Fundación Cardioinfantil entre 2014 y 2019 con infarto agudo de miocardio para evaluar la relación entre factores clínicos y la revascularización miocárdica quirúrgica.Cardiovascular disease is the main chronic non-communicable disease worldeide, configuring a high health burden (1–3). The treatment of acute myocardial infarction has its pillars in medical management and reperfusion therapy that can be percutaneous or surgical (CABG) (4–7). One of the limitations that arise when performing CABG is the need to washout P2Y12 inhibitors-type antiplatelets to decrease the risk of perioperative bleeding (8). Recently, some attempts have been made to identify factors that allow identifying patients with a high probability of having multivessel disease and an indication for CABG; However, the evaluated groups have been very heterogeneous and it has not been possible to propose strategies that predict with certainty(9–11). A retrospective case-control study will be carried out with adult patients cared for at Fundación Cardioinfantil between 2014 and 2019 with acute myocardial infarction to evaluate the relationship between clinical factors and surgical reperfusion strategy.2022-08-23 21:45:01: Script de automatizacion de embargos. Correo enviado 23ago2022: Hemos realizado la publicación de su documento: Factores asociados con revascularización miocárdica quirúrgica en pacientes con infarto agudo de miocardio: estudio de casos y controles en un hospital de alta complejidad de Bogotá, Colombia, entre 2014 y 2019, el cual puede consultar en el siguiente enlace: https://repository.urosario.edu.co/handle/10336/34769 Identificamos que ha marcado como bloqueado y/o restringido en el formulario, pero no realizo la notificación al correo edocur@urosario.edu.co, justificando la medida restrictiva al acceso del texto completo de su obra, frente a lo cual, el documento ha quedado embargado solo por un mes hasta el 23 de septiembre de 2022 en concordancia con las Políticas de Acceso Abierto de la Universidad. Si usted desea dejarlo con acceso abierto antes de finalizar dicho periodo o si por el contrario desea extender el embargo al finalizar este tiempo, puede enviar un correo a esta misma dirección realizando la solicitud. Tenga en cuenta que los documentos en acceso abierto propician una mayor visibilidad de su producción académica. De otra parte, si desea publicar su obra en una revista de prestigio, queremos invitarlo a tomar una asesoría con nuestros asesores de información del CRAI, quienes podrán brindarle orientación en la identificación de una revista adecuada para su obra y acompañamiento en la edición para publicación. La solicitud de asesoría puede agendarla en el siguiente link: https://n9.cl/agendamiento_servicios_crai2022-09-24 01:01:01: Script de automatizacion de embargos. info:eu-repo/date/embargoEnd/2022-09-2382 ppapplication/pdfhttps://doi.org/10.48713/10336_34769 https://repository.urosario.edu.co/handle/10336/34769spaUniversidad del RosarioEscuela de Medicina y Ciencias de la SaludEspecialización en Medicina InternaAtribución-NoComercial-CompartirIgual 2.5 ColombiaAbierto (Texto Completo)EL AUTOR, manifiesta que la obra objeto de la presente autorización es original y la realizó sin violar o usurpar derechos de autor de terceros, por lo tanto la obra es de exclusiva autoría y tiene la titularidad sobre la misma. PARGRAFO: En caso de presentarse cualquier reclamación o acción por parte de un tercero en cuanto a los derechos de autor sobre la obra en cuestión, EL AUTOR, asumirá toda la responsabilidad, y saldrá en defensa de los derechos aquí autorizados; para todos los efectos la universidad actúa como un tercero de buena fe. EL AUTOR, autoriza a LA UNIVERSIDAD DEL ROSARIO, para que en los términos establecidos en la Ley 23 de 1982, Ley 44 de 1993, Decisión andina 351 de 1993, Decreto 460 de 1995 y demás normas generales sobre la materia, utilice y use la obra objeto de la presente autorización. -------------------------------------- POLITICA DE TRATAMIENTO DE DATOS PERSONALES. Declaro que autorizo previa y de forma informada el tratamiento de mis datos personales por parte de LA UNIVERSIDAD DEL ROSARIO para fines académicos y en aplicación de convenios con terceros o servicios conexos con actividades propias de la academia, con estricto cumplimiento de los principios de ley. Para el correcto ejercicio de mi derecho de habeas data cuento con la cuenta de correo habeasdata@urosario.edu.co, donde previa identificación podré solicitar la consulta, corrección y supresión de mis datos.http://purl.org/coar/access_right/c_abf2Benjamin EJ, Muntner P, Alonso A, Bittencourt MS, Callaway CW, Carson AP, et al. Heart Disease and Stroke Statistics—2019 Update: A Report From the American Heart Association. Circulation. 2019 Mar 5;139(10):e56–528.Roth GA, Johnson C, Abajobir A, Abd-Allah F, Abera SF, Abyu G, et al. Global, Regional, and National Burden of Cardiovascular Diseases for 10 Causes, 1990 to 2015. J Am Coll Cardiol. 2017 Jul;70(1):1–25.Roth GA, Johnson CO, Abate KH, Abd-Allah F, Ahmed M, Alam K, et al. The Burden of Cardiovascular Diseases Among US States, 1990-2016. JAMA Cardiology. 2018 May 1;3(5):375.Ibanez B, James S, Agewall S, Antunes MJ, Bucciarelli-Ducci C, Bueno H, et al. 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation. European Heart Journal. 2018 Jan 7;39(2):119–77.Roffi M, Patrono C, Collet JP, Mueller C, Valgimigli M, Andreotti F, et al. 2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation. European Heart Journal. 2016 Jan 14;37(3):267–315.Amsterdam EA, Wenger NK, Brindis RG, Casey DE, Ganiats TG, Holmes DR, et al. 2014 AHA/ACC Guideline for the Management of Patients With Non–ST-Elevation Acute Coronary Syndromes. J Am Coll Cardiol. 2014 Dec;64(24):e139–228Layne K, Ferro A. Antiplatelet Therapy in Acute Coronary Syndrome. European cardiology review. 2016;69–76.Neumann FJ, Sousa-Uva M, Ahlsson A, Alfonso F, Banning AP, Benedetto U, et al. 2018 ESC/EACTS Guidelines on myocardial revascularization. European Heart Journal. 2019 Jan 7;40(2):87–165.Mehta RH, Chen AY, Pollack C V., Roe MT, Zalenski RJ, Clements EA, et al. Challenges in Predicting the Need for Coronary Artery Bypass Grafting at Presentation in Patients With Non–ST-Segment Elevation Acute Coronary Syndromes. The American Journal of Cardiology. 2006 Sep;98(5):624–7.Shafiq A, Jang JS, Kureshi F, Fendler TJ, Gosch K, Jones PG, et al. Predicting Likelihood for Coronary Artery Bypass Grafting After Non–ST-Elevation Myocardial Infarction: Finding the Best Prediction Model. The Annals of Thoracic Surgery. 2016 Oct;102(4):1304–11.Chew DP, Mahaffey KW, White HD, Huang Z, Hoekstra JW, Ferguson JJ, et al. Coronary artery bypass surgery in patients with acute coronary syndromes is difficult to predict. American Heart Journal. 2008 May;155(5):841–7.Kaptoge S, Pennells L, De Bacquer D, Cooney MT, Kavousi M, Stevens G, et al. World Health Organization cardiovascular disease risk charts: revised models to estimate risk in 21 global regions. The Lancet Global Health. 2019 Oct;7(10):e1332–45Fernández de Larrea-Baz N, Morant-Ginestar C, Catalá-López F, Gènova-Maleras R, Álvarez-Martín E. Disability-adjusted Life Years Lost to Ischemic Heart Disease in Spain. Revista Española de Cardiología (English Edition). 2015 Nov;68(11):968–75.Vedanthan R, Seligman B, Fuster V. Global Perspective on Acute Coronary Syndrome. Circulation Research. 2014 Jun 6;114(12):1959–75.Thygesen K, Alpert JS, Jaffe AS, Chaitman BR, Bax JJ, Morrow DA, et al. Fourth Universal Definition of Myocardial Infarction (2018). Circulation. 2018 Nov 13;138(20):e618–51.Thuijs DJFM, Kappetein AP, Serruys PW, Mohr FW, Morice MC, Mack MJ, et al. Percutaneous coronary intervention versus coronary artery bypass grafting in patients with three-vessel or left main coronary artery disease: 10-year follow-up of the multicentre randomised controlled SYNTAX trial. The Lancet. 2019 Oct;394(10206):1325–34.Garot P, Lefevre T. Treatment Selection for Multivessel Coronary Artery Disease. Cardiac Interventions Today. 2011;(January/February):54–9.De Innocentiis C, Zimarino M, De Caterina R. Is complete revascularisation mandated for all patients with multivessel coronary artery disease? Interventional Cardiology Review. 2018;13(1):45–50.Khan AR, Golwala H, Tripathi A, Riaz H, Kumar A, Flaherty MP, et al. Meta-analysis of Percutaneous Coronary Intervention Versus Coronary Artery Bypass Grafting in Left Main Coronary Artery Disease. The American Journal of Cardiology. 2017 Jun;119(12):1949– 56.Head SJ, Milojevic M, Daemen J, Ahn JM, Boersma E, Christiansen EH, et al. Mortality after coronary artery bypass grafting versus percutaneous coronary intervention with stenting for coronary artery disease: a pooled analysis of individual patient data. The Lancet. 2018 Mar;391(10124):939–48Lee CW, Ahn JM, Cavalcante R, Sotomi Y, Onuma Y, Suwannasom P, et al. Coronary Artery Bypass Surgery Versus Drug-Eluting Stent Implantation for Left Main or Multivessel Coronary Artery Disease. JACC: Cardiovascular Interventions. 2016 Dec;9(24):2481–9.Desperak P, Hawranek M, Hrapkowicz T, Zembala MO, Gąsior M. Comparison of multivessel percutaneous coronary intervention and coronary artery bypass grafting in patients with severe coronary artery disease presenting with non-ST-segment elevation acute coronary syndromes. Kardiologia Polska. 2018 Jul 24;76(10):1474–81.Bryer E, Stein E, Goldberg S. Multivessel Coronary Artery Disease. The Limitations of a “One-Size-Fits-All” Approach Emily. Mayo Clinic Proceedings: Innovations, Quality & Outcomes. 2020 Dec;4(6):638–41.Garcia S, Canoniero MJ, Chirinos JA, de Marchena E, Salerno T, Ferreira A. Development of a Score to Predict the Need for Coronary Artery Bypass Graft Surgery in Patients With Non-ST Segment Elevation Acute Coronary Syndromes. The Annals of Thoracic Surgery. 2004 Dec;78(6):2022–6.Bianco V, Kilic A, Gleason TG, Aranda-Michel E, Wang Y, Navid F, et al. Timing of coronary artery bypass grafting after acute myocardial infarction may not influence mortality and readmissions. The Journal of Thoracic and Cardiovascular Surgery. 2019 Dec;Biancari F, Airaksinen KEJ, Lip GYH. Benefits and risks of using clopidogrel before coronary artery bypass surgery: Systematic review and meta-analysis of randomized trials and observational studies. The Journal of Thoracic and Cardiovascular Surgery. 2012 Mar;143(3):665-675.e4Don CW, Roe MT, Li S, Fraulo E, Pomerantsev E, Palacios I, et al. Temporal trends and practice variations in clopidogrel loading doses in patients with non–ST-segment elevation myocardial infarction, from the National Cardiovascular Data Registry. American Heart Journal. 2011 Apr;161(4):689–97.Burke MA, Lee R, Fintel DJ. Early clopidogrel use in non–ST elevation acute coronary syndrome and subsequent coronary artery bypass grafting. American Heart Journal. 2011 May;161(5):832–41.Collet JP, Thiele H, Barbato E, Barthélémy O, Bauersachs J, Bhatt DL, et al. 2020 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation. European Heart Journal. 2020 Aug 29;1–79Montalescot G, Bolognese L, Dudek D, Goldstein P, Hamm C, Tanguay JF, et al. Pretreatment with Prasugrel in Non–ST-Segment Elevation Acute Coronary Syndromes. New England Journal of Medicine. 2013 Sep 12;369(11):999–1010.Dworeck C, Redfors B, Angerås O, Haraldsson I, Odenstedt J, Ioanes D, et al. Association of Pretreatment With P2Y12 Receptor Antagonists Preceding Percutaneous Coronary Intervention in Non-ST-Segment Elevation Acute Coronary Syndromes With Outcomes. JAMA Netw Open. 2020;3(10):e2018735Schüpke S, Neumann FJ, Menichelli M, Mayer K, Bernlochner I, Wöhrle J, et al. Ticagrelor or Prasugrel in Patients with Acute Coronary Syndromes. New England Journal of Medicine. 2019;381(16):1524–34Libby P, Theroux P. Pathophysiology of Coronary Artery Disease. Circulation. 2005 Jun 28;111(25):3481–8.Crea F, Libby P. Acute coronary syndromes: The way forward from mechanisms to precision treatment. Circulation. 2017;136(12):1155–66.Scholz KH, Maier SKG, Maier LS, Lengenfelder B, Jacobshagen C, Jung J, et al. Impact of treatment delay on mortality in ST-segment elevation myocardial infarction (STEMI) patients presenting with and without haemodynamic instability: Results from the German prospective, multicentre FITT-STEMI trial. European Heart Journal. 2018;39(13):1065–74Dharma S. Comparison of Real-Life Systems of Care for ST-Segment Elevation Myocardial Infarction. Vol. 15, Global heart. 2020. p. 66.Núñez Aragón R, Pedro-Botet Montoya ML, Mateu Pruñonosa L, Vallejo Camazón N, Sopena Galindo N, Casas García I, et al. Factores asociados y análisis descriptivo de la endocarditis infecciosa adquirida en el entorno hospitalario de un centro terciario de referencia. Enfermedades Infecciosas y Microbiología Clínica. 2013 Jan;31(1):15–22Calé R, Pereira H, Pereira E, Vitorino S, de Mello S. Time to reperfusion in high-risk patients with myocardial infarction undergoing primary percutaneous coronary intervention. Revista Portuguesa de Cardiologia. 2019 Sep;38(9):637–46.Dauerman HL, Gogo PB, Sobel BE. Reperfusion therapies for acute ST elevation myocardial infarction. In: Cardiac Intensive Care. Third Edit. Elsevier; 2018. p. 103- 116.e5.Dávila FA, Pardo DA, Lewis AJ, Vargas L. Análisis de supervivencia según la oportunidad de atención en la enfermedad coronaria. Revista Colombiana de Cardiología. 2016 Sep;23(5):346–50.Cano N. Epidemiología del infarto agudo del miocardio en el Hospital Santa Sofía de Manizales. Estudio descriptivo (junio de 2000 a junio de 2003). Rev colomb cardiol. 2004;11(3):157–63.Méndez-Muñoz PC, Martínez-Espitia E, Paba-Rojas CE, Rodríguez-Perdomo J, SilvaHernández LM. Mortalidad por enfermedad isquémica cardiaca según variables sociodemográficas en Bogotá, Colombia. Revista Salud Bosque. 2020;10(1):65–78.Boyle AJ. Predicting Left Main and Triple-vessel Disease in ACS. 2011.Avci BK, Ikitimur B, Tok OO, Cimci M, Erturk E, Omar TB, et al. OP-079 The Role of GRACE Score in Prediction of High Risk Coronary Anatomy in Patients with Non-ST Elevation Acute Coronary Syndrome. The American Journal of Cardiology. 2015 Mar;115:S35.Mota F Da, Azevedo P, Fernandes R, Guedes J, Bento D, Marques N, et al. Prediction of CABG indication in patients admitted for NSTEMI with the new CABG DAPE2S score. European Heart Journal ( 2016 ) 37 ( Abstract Supplement ), 572. 2019.Bahall M, Legall G, Khan K. Quality of life among patients with cardiac disease: the impact of comorbid depression. Health and Quality of Life Outcomes. 2020 Dec 17;18(1):189Ko H young, Lee J kwon, Shin J young, Jo E. Health-Related Quality of Life and Cardiovascular Disease Risk in Korean Adults. Korean Journal of Family Medicine. 2015;36(6):349.Ram E, Sternik L, Klempfner R, Iakobishvili Z, Peled Y, Shlomo N, et al. Outcomes of different revascularization strategies among patients presenting with acute coronary syndromes without ST elevation. The Journal of Thoracic and Cardiovascular Surgery. 2019 Sep;Qintar M, Humphries KH, Park JE, Arnold S V, Tang Y, Jones P, et al. Individualizing Revascularization Strategy for Diabetic Patients With Multivessel Coronary Disease. J Am Coll Cardiol. 2019 Oct;74(16):2074–84.Qintar M, Humphries KH, Park JE, Arnold S V, Tang Y, Jones P, et al. Individualizing Revascularization Strategy for Diabetic Patients With Multivessel Coronary Disease. J Am Coll Cardiol. 2019 Oct;74(16):2074–84.Ge J, Li J, Yu H, Hou B. Hypertension Is an Independent Predictor of Multivessel Coronary Artery Disease in Young Adults with Acute Coronary Syndrome. International Journal of Hypertension. 2018 Nov 13;2018:1–9.José de Carvalho Cantarelli M, Castello HJ, Gonçalves R, Gioppato S, Batista de Freitas Guimarães J, Pracchia Ribeiro EK, et al. Independent predictors of multivessel coronary artery disease: results from Angiocardio Registry. Revista Brasileira de Cardiologia Invasiva (English Edition). 2015 Oct;23(4):266–70Warrington KJ, Kent PD, Frye RL, Lymp JF, Kopecky SL, Goronzy JJ, et al. Rheumatoid arthritis is an independent risk factor for multi-vessel coronary artery disease: a case control study. Arthritis Res Ther. 2005;7(5):R984-91Kosuge M, Ebina T, Hibi K, Morita S, Endo M, Maejima N, et al. An Early and Simple Predictor of Severe Left Main and/or Three-Vessel Disease in Patients With Non–STSegment Elevation Acute Coronary Syndrome. The American Journal of Cardiology. 2011 Feb;107(4):495–500Fu X, Wilson P, Chung WSF. Time-to-reperfusion in patients with acute myocardial infarction and mortality in prehospital emergency care: meta-analysis. BMC Emergency Medicine. 2020 Dec 26;20(1):65.Woodward M. Epidemiology Study Design and Data Analysis. Chapman & Hall/CRC, editor. New York; 2005. 381-426. pTeam RC. R: A language and environment for statistical computing. Vienna, Austria: R Foundation for Statistical Computing; 2020Mahmood SS, Levy D, Vasan RS, Wang TJ. The Framingham Heart Study and the epidemiology of cardiovascular disease: a historical perspective. The Lancet. 2014 Mar;383(9921):999–1008Sarmiento Agamez OD. Registro colombiano de pacientes con Síndrome Coronario Agudo Cohorte Fundación Clínica Shaio . [Bogotá]: Fundación Clínica Shaio; 2022.Chavarriaga JC. Características epidemiológicas, clínicas, tratamiento y pronóstico de los pacientes con diagnóstico de síndrome coronario agudo en unidad especializada. Acta Medica Colombiana. 2014;39(1).Lanas F, Avezum A, Bautista LE, Diaz R, Luna M, Islam S, et al. Risk Factors for Acute Myocardial Infarction in Latin America. Circulation. 2007 Mar 6;115(9):1067–74.García A JCMPAJAAMCRMLGMJTA. Registro Mexicano de Síndromes Coronarios Agudos. Archivos de cardiología de México. 2005;75(1).Rogers WJ, Frederick PD, Stoehr E, Canto JG, Ornato JP, Gibson CM, et al. Trends in presenting characteristics and hospital mortality among patients with ST elevation and nonST elevation myocardial infarction in the National Registry of Myocardial Infarction from 1990 to 2006. American Heart Journal. 2008 Dec;156(6):1026–34.Bainey KR, Welsh RC, Alemayehu W, Westerhout CM, Traboulsi D, Anderson T, et al. Population-level incidence and outcomes of myocardial infarction with non-obstructive coronary arteries (MINOCA): Insights from the Alberta contemporary acute coronary syndrome patients invasive treatment strategies (COAPT) study. International Journal of Cardiology. 2018 Aug;264:12–7.Pasupathy S, Air T, Dreyer RP, Tavella R, Beltrame JF. Systematic Review of Patients Presenting With Suspected Myocardial Infarction and Nonobstructive Coronary Arteries. Circulation. 2015 Mar 10;131(10):861–70.Mehta SR, Bossard M. Acute Coronary Syndromes and Multivessel Disease. JACC: Cardiovascular Interventions. 2020 Jul;13(13):1568–70.Tarantini G, Mojoli M, Varbella F, Caporale R, Rigattieri S, Andò G, et al. Timing of Oral P2Y12 Inhibitor Administration in Patients With Non-ST-Segment Elevation Acute Coronary Syndrome. J Am Coll Cardiol. 2020 Nov;76(21):2450–9.García AM. Infarto agudo de miocardio con supradesnivel persistente del segmento ST: Registro multicéntrico SCAR (Síndromes Coronarios Agudos en Argentina) de la Sociedad Argentina de Cardiología. Rev argent cardiol. 2014;82(4)instname:Universidad del Rosarioreponame:Repositorio Institucional EdocUREnfermedad cardiovascularEnfermedad crónica no transmisibleTratamiento del infarto agudo de miocardioRevascularización miocárdica quirúrgicaEnfermedades616600Heart diseaseChronic non-communicable diseaseTreatment of acute myocardial infarctionSurgical myocardial revascularizationFactores asociados con revascularización miocárdica quirúrgica en pacientes con infarto agudo de miocardio: estudio de casos y controles en un hospital de alta complejidad de Bogotá, Colombia, entre 2014 y 2019Factors associated with surgical myocardial revascularization in patients with acute myocardial infarction: a case-control study in a high-complexity hospital in Bogotá, Colombia, between 2014 and 2019bachelorThesisTrabajo de gradoTrabajo de gradohttp://purl.org/coar/resource_type/c_7a1fORIGINALFactoresasociadosconrevascularizacionmiocardicaquirurgicaenpacientes.pdfFactoresasociadosconrevascularizacionmiocardicaquirurgicaenpacientes.pdfArtículo principalapplication/pdf780969https://repository.urosario.edu.co/bitstreams/bcbfd0df-4e8b-4458-9fcc-9a5cf258e753/download5804432f7a619cb8a175bf6b84475a3dMD56LICENSElicense.txtlicense.txttext/plain1475https://repository.urosario.edu.co/bitstreams/83d1d591-91d0-40ac-8400-d981026e35a0/downloadfab9d9ed61d64f6ac005dee3306ae77eMD57TEXTFactoresasociadosconrevascularizacionmiocardicaquirurgicaenpacientes.pdf.txtFactoresasociadosconrevascularizacionmiocardicaquirurgicaenpacientes.pdf.txtExtracted texttext/plain130827https://repository.urosario.edu.co/bitstreams/fea9b021-31a8-461c-825b-99d13eb07458/downloadcbcc2760c06126f5c126015c9b27aa90MD58THUMBNAILFactoresasociadosconrevascularizacionmiocardicaquirurgicaenpacientes.pdf.jpgFactoresasociadosconrevascularizacionmiocardicaquirurgicaenpacientes.pdf.jpgGenerated Thumbnailimage/jpeg2412https://repository.urosario.edu.co/bitstreams/98a01777-3783-4236-bbc9-5a697ff57689/downloadde12a329865f9ce878a4be07fe386462MD5910336/34769oai:repository.urosario.edu.co:10336/347692022-08-24 03:04:43.939https://repository.urosario.edu.coRepositorio institucional EdocURedocur@urosario.edu.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