Uso de las variables clínicas para la discriminación del SCA en los servicios de urgencia hospitalarios

Abstract

Acute coronary syndrome in the Emergency Department remains a problem, its discrimination is based on: clinical parameters, ECG, and cardiac enzymes. The cost-effectiveness of clinical parameters is being studied. In patients with chest pain seen in EDs the association between cardiovascular risk factors, and clinical characteristics of pain with a diagnosis of ACS is estimated. Diabetes and hypertension were not associated with the presence of SCA in the overall series. It generated a significant age-related interaction with cardiovascular risk in patients under the age of 65. Related variables were the male gender, hypertension (as a cardiovascular risk factor), antiplatelet therapy, snuff and hypertension during the event. In patients over the age of 65 associated variables were dyslipidemia, previous CI, Killip, cardiac arrest, heart rate, pain on admission, typical pain response to nitroglycerin and more than one episode of pain. Multivariate analysis identified as independent variables for patients under 65: male, hypertension (as CRF), antiplatelet therapy and pain upon admission and for patients over 65, prior ischemic heart disease, Killip, and number of episodes; while typical chest pain is present in both groups.