No abstract

The number of CR programs in South America appears to be insufficient for a population with a high and growing burden of cardiovascular disease. In addition, there appears to be a significant need for standardization of CR program components and services in the region.

No abstract

No abstract

. MeSH search terms and domains were related to CVD, prediction rules, Latin America (including the Caribbean), and Hispanics in the United States. Database searches were supplemented by correspondence with experts in the field. 1.68 (95% CI, incident myocardial infarction, 1.36 (95% CI, and CHD death, 1.21 (95% CI,. In Ecuador, a prediction model for CVD and total deaths in hypertensive patients had an area under the curve (AUC) of 0.79 (95% CI,, while the World Health Organization method had an AUC of 0.74 (95% CI,. A study predicting mortality risk in people with Chagas' disease had an AUC of 0.81 (95% CI, According to the World Health Organization (WHO), about 25% of all annual deaths in Latin America are due to cardiovascular diseases (CVD) (2, 3). Cardiovascular risk factors, including obesity, hypertension, hypercholesterolemia, diabetes mellitus, and tobacco use are highly prevalent in Latin America and contribute to three-fourths of its CVD cases (4). The prevalence of most, if not all, of these factors has been steadily increasing in recent years in Latin America, and the trend is expected to continue (3). Results. A total of 1 655 abstracts were identified, of which five cohorts with a total of 13 142 subjects met inclusion criteria. A Mexican cohort showed that the predicted/observed event-rate ratio for coronary heart disease (CHD) according to the Framingham risk score (FRS) wasData regarding CVD burden and trends among Hispanics living in the United States is also alarming and represents the most likely cause of death among this population (5), about 31% of all deaths (6). The prevalence of heart disease is 8.1% in Hispanics and 12.1% in Caucasians (7) and the prevalence of obesity (8), diabetes mellitus, hypertension, and dyslipidemia, is generally higher among Hispanics than Caucasians (7, 9).Estimation of CVD risk using prediction models is considered of high importance to public health since it can aid clinical decision-making, guide therapy, and make interventions more cost effective. It may also help direct public policy when measuring risk trends at the population level (10). In the last few decades, several cardiovascular risk prediction models have been created and introduced worldwide.The Framingham risk score (FRS) was the first of such tools and is arguably the most commonly used model for calculating 10-year risk for CVD events in the world. The FRS has been validated and recalibrated in several different populations, including Australia, China, Japan, New Zealand, Spain, and the United States (11)(12)(13)(14). These studies have shown that the FRS may overestimate CVD risk in some populations and under estimate it in others. Some other prediction models include the Prospective Cardiovascular Munster Heart Study (PROCAM) (15), the Reynolds score (16), and the Systematic Coronary Risk Evaluation system (SCORE) (17).The aim of this study was to assess the use and validity of CVD risk prediction models in Latin America and the Caribbean and among Hispanic populations in the United Sta...

No abstract

A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was 'is a minimally invasive approach for resection of benign cardiac masses superior to standard full sternotomy?' A total of 50 papers were found using the reported search, of which, 11 represented the best evidence to answer the clinical question. The authors, country, journal, date of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. All 11 papers were retrospective studies, from which 4 were case-control studies comparing the minimally invasive approach with conventional full sternotomy, and 7 were case series. There were two minimally invasive techniques used, a right mini-thoracotomy and a partial hemi-sternotomy, the former being the most commonly used. The resection of benign cardiac masses is a low-risk procedure, with no mortality or conversions to full sternotomy reported. From the 4 case-control studies, cross-clamp time was similar in both groups, and only one report found a prolonged perfusion time with the minimally invasive approach. The incidence of major postoperative complications, including bleeding requiring reoperation (average from case-control studies: 0-4.5 vs 0-5.8%), renal failure (0 vs 0-10%) and prolonged ventilation (6-13 vs 11-19%), for the two approaches was similar. The incidence of postoperative stroke was better for the minimally invasive approach in one study (0 vs 14%, P = 0.023). The main advantages of this technique are shorter intensive care unit (26-31 vs 46-60 h) and hospital stay (3.6-5.2 vs 6.2-7.4 days), the minimally invasive approach being significantly better in one and three reports, respectively. We conclude that minimally invasive resection of a benign cardiac mass using a right mini-thoracotomy approach can be performed with an operative morbidity and mortality at least similar to the standard full sternotomy approach. The information currently available for the minimally invasive approach for the resection of benign cardiac masses is limited and based only on retrospective studies and, therefore, prospective studies are required to confirm the potential benefits of minimally invasive surgery.

Despite the recognized value of CR in the care of patients after a cardiac event, this study reveals the need for further development of such programs and improvement of patient referrals.