000			nab a22 7a 4500
999			_c17858 _d17858
003			PC17858
005			20240528140404.0
008			240528b xxu||||| |||| 00| 0 eng d
040			_cH12O
041			_aeng
100			_91251 _aEscribano Subías, Pilar _eCardiología
245	0	0	_aGlobal cardiac risk assessment in the Registry Of Pregnancy And Cardiac disease: results of a registry from the European Society of Cardiology. _h[artículo]
260			_bEuropean journal of heart failure, _c2016
300			_a18(5):523-33.
500			_aFormato Vancouver: Van Hagen IM, Boersma E, Johnson MR, Thorne SA, Parsonage WA, Escribano Subías P et al; ROPAC investigators and EORP team. Global cardiac risk assessment in the Registry Of Pregnancy And Cardiac disease: results of a registry from the European Society of Cardiology. Eur J Heart Fail. 2016 May;18(5):523-33.
501			_aPMID: 27006109
504			_aContiene 28 referencias
520			_aAims: To validate the modified World Health Organization (mWHO) risk classification in advanced and emerging countries, and to identify additional risk factors for cardiac events during pregnancy. Methods and results: The ongoing prospective worldwide Registry Of Pregnancy And Cardiac disease (ROPAC) included 2742 pregnant women (mean age ± standard deviation, 29.2 ± 5.5 years) with established cardiac disease: 1827 from advanced countries and 915 from emerging countries. In patients from advanced countries, congenital heart disease was the most prevalent diagnosis (70%) while in emerging countries valvular heart disease was more common (55%). A cardiac event occurred in 566 patients (20.6%) during pregnancy: 234 (12.8%) in advanced countries and 332 (36.3%) in emerging countries. The mWHO classification had a moderate performance to discriminate between women with and without cardiac events (c-statistic 0.711 and 95% confidence interval (CI) 0.686-0.735). However, its performance in advanced countries (0.726) was better than in emerging countries (0.633). The best performance was found in patients with acquired heart disease from developed countries (0.712). Pre-pregnancy signs of heart failure and, in advanced countries, atrial fibrillation and no previous cardiac intervention added prognostic value to the mWHO classification, with a c-statistic of 0.751 (95% CI 0.715-0.786) in advanced countries and of 0.724 (95% CI 0.691-0.758) in emerging countries. Conclusion: The mWHO risk classification is a useful tool for predicting cardiac events during pregnancy in women with established cardiac disease in advanced countries, but seems less effective in emerging countries. Data on pre-pregnancy cardiac condition including signs of heart failure and atrial fibrillation, may help to improve preconception counselling in advanced and emerging countries.
710			_9119 _aServicio de Cardiología
856			_uhttp://pc-h12o-es.m-hdoct.a17.csinet.es/pdf/pc/1/pc17858.pdf _ySolicitar documento
942			_2ddc _cART _n0