RT info:eu-repo/semantics/doctoralThesis
T1 Papel de biomarcadores y escalas pronósticas en la atención prehospitalaria de las enfermedades cardiovasculares agudas
A1 Castro Portillo, Enrique
A2 Universidad de Valladolid. Escuela de Doctorado
K1 Patología cardiovascular
K1 Biomarker
K1 Biomarcador
K1 Early warning score
K1 Escala de alerta temprana
K1 Point of care
K1 Punto de atneción
K1 Acute cardiovascular disease
K1 Enfermedad cardiovascular aguda
K1 3205 Medicina Interna
AB In this thesis by compendium of publications, three studies have been carried out and published. The main objective of these studies is to demonstrate the usefulness of serum biomarkers measured at the point of care (troponins and mSOFA), as well as the mSOFA risk scale, in predicting mortality at the pre-hospital level in patients treated for acute cardiovascular pathology: 1.	Cardiac troponines determined at the point of care are an excellent predictor of in-hospital mortality 28 days after the index event in patients treated for acute pathologies of any cause.2.	Cardiac troponin performance was not affected by gender, age or patient diagnosis, although higher levels were found in patients aged 18-49 years and in those with a diagnosis of acute cardiovascular disease.3.	Pre-hospital NT-proBNP had a very good ability to predict in-hospital mortality from acute cardiovascular disease at 2 and 28 days after the index event. 4.	NT-proBNP proved useful in predicting mortality in patients with suspected ischaemic heart disease and arrhythmias, but especially in patients with suspected syncope. However, this biomarker does not appear to be useful for predicting prognosis in patients with acute heart failure. 5.	The mSOFA is a prognostic scale with an excellent ability to predict mortality at both 2 and 90 days in patients treated for acute cardiovascular disease in the pre-hospital setting. 6.	Although the TIMI Risk Index (TIMI), the Modified Shock Index (MSI), the Cardiac Arrest Risk Triage (CART) and the National Early Warning Score 2 (NEWS2) demonstrated an acceptable ability to predict 2- and 90-day mortality in patients with acute cardiovascular disease, the mSOFA scale was superior to all of them. 7.	The mSOFA had a very good ability to predict mortality in the 4 acute cardiovascular disease diagnostic groups studied: acute heart failure, ischaemic heart disease, arrhythmia and syncope.
YR 2023
FD 2023
LK https://uvadoc.uva.es/handle/10324/65188
UL https://uvadoc.uva.es/handle/10324/65188
LA spa
NO Escuela de Doctorado
DS UVaDOC
RD 11-jul-2024