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Recently, we have witnessed major improvements in cancer treatment. Early diagnosis and development of new therapies have reduced cancer-related mortality. However, these new therapies, along with greater patient survival, are associated with an increase in untoward effects, particularly in the cardiovascular system. Although cardiotoxicity induced by oncologic treatments affects predominantly the myocardium, it can also involve other structures of the cardiovascular system, becoming one of the main causes of morbidity and mortality in those who survive cancer. The main objective of cardio-oncology is to achieve the maximum benefits of oncologic treatments while minimizing their deleterious cardiovascular effects. It harbors the stratification of patients at risk of cardiotoxicity, the implementation of diagnostic tools (imaging techniques and biomarkers) for early diagnosis, preventive strategies and early treatment options for the complications. Herein, we discuss the basic knowledge for the implementation of cardio-oncology units and their role in the management of cancer patients, the diagnostic tools available to detect cardiotoxicity and the present therapeutic options.

Objectives To describe the characteristics of patients who undergo balloon pulmonary angioplasty (BPA) for inoperable chronic thromboembolic pulmonary hypertension (CTEPH) and report the mid‐term outcomes. Background BPA has been recently introduced in Latin America. Mid‐term results have not been published. Methods Prospective Chilean Registry of inoperable CTEPH patients who underwent BPA. Clinical variables were analyzed at baseline, after each procedure and at follow‐up. Hemodynamic variables were recorded before and after the last BPA. Results Between August 2016 and September 2019, 22 patients (17 women), 59 ± 12.7 years, underwent 81 BPA and were followed for as long as 33.1 months (mean 17.3 ± 7.5). Mean pulmonary artery pressure decreased by 17.4% (51.1 ± 12 vs. 42.2 ± 13 mmHg, p = .001), pulmonary vascular resistance by 23.9% (766.7 ± 351 vs. 583 ± 346 dynes/s/cm−5, p = .001), cardiac index increased by 8% (2.3 ± 0.54 vs. 2.5 ± 0.54 L/min/m2, p = .012), N‐terminal pro‐B‐type natriuretic peptide decreased by 73.8% (1,685 ± 1,045 vs. 441.8 ± 276 pg/dl, p = .006), and 6‐min walk distance improved by 135 m (316.7 ± 94 vs. 451.1 ± 113 m, p = .001). One patient (4.5%) developed lung reperfusion injury and four patients (18.2%) had minor bleeding (hemoptysis), after the procedure. There was no mortality associated with BPA. Conclusions Our results confirm that BPA for inoperable CTEPH is a relatively safe procedure that improves clinical and hemodynamic parameters in the mid‐term. This therapy should be considered as an alternative, mainly in places where access to PAH therapy or surgery is restricted.

La revascularización coronaria híbrida busca combinar el beneficio de las técnicas quirúrgicas y percutáneas para un manejo óptimo de pacientes seleccionados con enfermedad coronaria obstructiva multivaso. Esto permite asociar el beneficio del puente de arteria mamaria interna izquierda a la arteria descendente anterior (ADA) y combinarlo con el implante de stents en lesiones no-ADA. El objetivo de este tra-bajo es hacer una revisión de la literatura disponible con énfasis en sus resultados clínicos comparados con la estrategia convencional. Palabras clave: Revascularización híbrida coronaria, enfermedad de arteria coronaria, cirugía de bypass de arteria coronaria, intervención coronaria percutánea.

La coronarioectasia difiere en los factores de riesgo clásicos... Fuensalida A., et al. La coronarioectasia difiere en los factores de riesgo clásicos... Fuensalida A., et al. La coronarioectasia difiere en los factores de riesgo clásicos... Fuensalida A., et al.

Methods: This was a retrospective case-control study including patients with CBA between 2010-2016. This group was compared with the same number of controls with STEMI matched by age and sex. Clinical characteristics, procedure variables and overall mortality as well as cardiac mortality were analyzed using Student's T test, Chi squared test and Kaplan Meier curves (significance set at p <0.05). Results: We identified 63 patients undergoing CBA (76 procedures). The most commonly intervened bypasses were to the circumflex artery (48.7%). There were 18 (28.5%) patients who died in the CBA group and 6 (9.5%) patients in the STEMI group, which resulted in an excess of global mortality risk in patients with CBA (HR 3.02, 95% CI 1.11-8.22, p = 0.02). This difference was driven by a higher non-cardiac mortality in the CBA group (12.7% (n = 8) vs 3.2% (n = 2) [p = 0.04]) Conclusion: Patients undergoing CBA have a mortality rate more than three times that of the STEMI patients, mainly due to a higher non-cardiac mortality.

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Los autores declaran no tener conflictos de interés en relación con este manuscrito.