{"title":"Escenario IV. Tratamiento tras un síndrome coronario agudo en zonas rurales","authors":"Manuel Martínez-Sellés , Carlos Escobar","doi":"10.1016/S1131-3587(22)00012-7","DOIUrl":null,"url":null,"abstract":"<div><p>Algunas estrategias para mejorar la prevención secundaria y el control lipídico tras un síndrome coronario agudo (SCA) son poco aplicables a zonas rurales. Nuestro objetivo es elaborar un documento para adaptar las recomendaciones del ACS-Europath (#RutaSCA) a la realidad de las zonas rurales españolas. Mediante una revisión de la literatura y las diferentes propuestas del ACS-Europath, siempre teniendo en cuenta las peculiaridades de las zonas rurales, se plasman una serie de iniciativas prácticas adaptadas a ese medio. Se diseñó un algoritmo de derivación del paciente con SCA del ACS-Europath aplicable a medios rurales. Este algoritmo abarca la mayoría de las situaciones clínicas de los pacientes que han sufrido un SCA cuyo seguimiento se hace en un medio rural. Se ha puesto especial énfasis en garantizar un adecuado control del colesterol unido a lipoproteínas de baja densidad (cLDL) lo antes posible y cómo hacerlo en ese medio. La prevención secundaria y el control lipídico tras un SCA deben ser prioritarios, también en el medio rural. Diversos recursos, como las consultas a distancia, pueden facilitar el logro de los objetivos de control del cLDL en esta situación.</p></div><div><p>Some strategies for improving secondary prevention and controlling lipid levels after an acute coronary syndrome (ACS) are not suitable for rural areas. Our aim was to adapt the recommendations of the ACS-Europath (#ACSpathway) initiative to the reality of life in rural Spain. A review of the literature and of the various ACS-Europath proposals was carried out that took into account the particular characteristics of rural areas. We produced a series of practical proposals tailored to a rural setting. An algorithm for the referral of patients with ACS that is applicable in rural settings was developed from the ACS-Europath proposals. This algorithm covers the majority of clinical situations in which patients who have experienced an ACS are followed up in a rural environment. We placed particular emphasis on ensuring that the low-density lipoprotein (LDL) cholesterol level is well-controlled as quickly as possible and on achieving that goal in a rural setting. Secondary prevention and lipid level control are priorities after ACS in rural areas, as they are in other settings. A range of tools, including teleconsultations, is available for helping to achieve the goal of LDL cholesterol control in rural areas.</p></div>","PeriodicalId":34926,"journal":{"name":"Revista Espanola de Cardiologia Suplementos","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Revista Espanola de Cardiologia Suplementos","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1131358722000127","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
Abstract
Algunas estrategias para mejorar la prevención secundaria y el control lipídico tras un síndrome coronario agudo (SCA) son poco aplicables a zonas rurales. Nuestro objetivo es elaborar un documento para adaptar las recomendaciones del ACS-Europath (#RutaSCA) a la realidad de las zonas rurales españolas. Mediante una revisión de la literatura y las diferentes propuestas del ACS-Europath, siempre teniendo en cuenta las peculiaridades de las zonas rurales, se plasman una serie de iniciativas prácticas adaptadas a ese medio. Se diseñó un algoritmo de derivación del paciente con SCA del ACS-Europath aplicable a medios rurales. Este algoritmo abarca la mayoría de las situaciones clínicas de los pacientes que han sufrido un SCA cuyo seguimiento se hace en un medio rural. Se ha puesto especial énfasis en garantizar un adecuado control del colesterol unido a lipoproteínas de baja densidad (cLDL) lo antes posible y cómo hacerlo en ese medio. La prevención secundaria y el control lipídico tras un SCA deben ser prioritarios, también en el medio rural. Diversos recursos, como las consultas a distancia, pueden facilitar el logro de los objetivos de control del cLDL en esta situación.
Some strategies for improving secondary prevention and controlling lipid levels after an acute coronary syndrome (ACS) are not suitable for rural areas. Our aim was to adapt the recommendations of the ACS-Europath (#ACSpathway) initiative to the reality of life in rural Spain. A review of the literature and of the various ACS-Europath proposals was carried out that took into account the particular characteristics of rural areas. We produced a series of practical proposals tailored to a rural setting. An algorithm for the referral of patients with ACS that is applicable in rural settings was developed from the ACS-Europath proposals. This algorithm covers the majority of clinical situations in which patients who have experienced an ACS are followed up in a rural environment. We placed particular emphasis on ensuring that the low-density lipoprotein (LDL) cholesterol level is well-controlled as quickly as possible and on achieving that goal in a rural setting. Secondary prevention and lipid level control are priorities after ACS in rural areas, as they are in other settings. A range of tools, including teleconsultations, is available for helping to achieve the goal of LDL cholesterol control in rural areas.
期刊介绍:
Revista Española de Cardiología, is an international scientific journal dealing with cardiovascular medicine. Revista Española de Cardiología, the official publication of the Spanish Society of Cardiology, publishes research articles related to cardiovascular diseases. Articles are published in Spanish for the paper edition and in both Spanish and English in the electronic edition, which is available on the Internet. Regular sections include original articles reporting clinical or basic research, brief reports, review articles, editorials and letters to the Editor.