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Gefaell Larrondo I, Guisado-Clavero M, Pérez Álvarez M, Ramos del Río L, Castelo Jurado M, Ares Blanco S. Seguimiento de los pacientes con cardiopatía isquémica en Atención Primaria durante la pandemia por COVID-19. REVISTA CLÍNICA DE MEDICINA DE FAMILIA 2023. [DOI: 10.55783/rcmf.160103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023] Open
Abstract
Objetivo: describir el seguimiento de los factores de riesgo cardiovascular modificables (FRCM) de los pacientes con cardiopatía isquémica (CI) en un centro de salud durante el primer año la pandemia por COVID-19.
Material y métodos: estudio observacional ambispectivo de un centro de salud de Madrid.
Participantes: pacientes diagnosticados de CI antes de 2020, > 45 años (n: 257).
Seguimiento: del 13/03/2020 al 13/03/2021.
Variables: sociodemográficas, comorbilidades, análisis de sangre (AS), colesterol asociado a lipoproteínas de baja densidad (c-LDL), exploración física (tensión arterial [TA] e índice de masa corporal [IMC]), eventos cardiovasculares (ECV) y fallecimiento en el seguimiento.
Se realizó en tres períodos: situación basal: registro previo al inicio de la pandemia; primer período: del 13/03/2020 al 13/09/2020; segundo período: del 14/09/2020 al 13/03/2021. Datos obtenidos de la historia clínica electrónica. Análisis: STATA16.
Resultados: se hizo el seguimiento de 257 pacientes (edad: 73,14 ± 0,7; 67,3% hombres) diagnosticados de CI hace 7 años (rango intercuartílico [RIC]: 4-14). AS (al 65,6% de los pacientes se les hizo análisis en el primer período versus al 20,6% en el segundo período del estudio), TA (57,5% versus 18,6%) e IMC (29,5% versus 7,7%). Mejoraron el c-LDL hasta 2,2 mg/dL, y el IMC, 0,6 kg/m2. Empeoró la TA sistólica hasta 6,3 mmHg y la diastólica 2,5 mmHg. Un 7,7% sufrió un ECV en el primer período y un 5,8% en el segundo. Fallecieron 9 pacientes durante el seguimiento.
Conclusión: casi dos tercios de los pacientes con CI habían realizado seguimiento de LDL y TA en los 6 primeros meses tras el inicio de la pandemia. El número de seguimientos caía a 1/3 al año. El IMC fue la variable menos evaluada
Palabras clave: COVID-19, SARS-CoV-2, isquemia miocárdica, factores de riesgo de enfermedad cardíaca, cuidados posteriores.
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Affiliation(s)
| | - Marina Guisado-Clavero
- Unidad Docente Multiprofesional de Atención Familiar y Comunitaria del Área NortComunidad de Madrid. Madrid (España)
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Martinelli I, Timotin A, Moreno-Corchado P, Marsal D, Kramar S, Loy H, Joffre C, Boal F, Tronchere H, Kunduzova O. Galanin promotes autophagy and alleviates apoptosis in the hypertrophied heart through FoxO1 pathway. Redox Biol 2021; 40:101866. [PMID: 33493902 PMCID: PMC7823211 DOI: 10.1016/j.redox.2021.101866] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 01/10/2021] [Accepted: 01/11/2021] [Indexed: 12/12/2022] Open
Abstract
Autophagy and apoptosis are powerful regulators of multiple facets of cellular metabolism and homeostasis. Here, we uncover that galanin, a pleiotropic peptide, regulates cardiac autophagy and deactivates apoptotic cell death through the Forkhead box protein O1 (FoxO1) pathway. In hypertrophied heart, galanin promotes autophagy and metabolic shift from fatty acid (FA) to glucose oxidation and preserves mitochondrial integrity. In cardiomyoblasts, galanin triggers autophagosome formation and alleviates hypertrophy, apoptotic cell death, and mitochondrial stress. Mechanistically, galanin dictates cell autophagic and anti-apoptotic phenotypes through FoxO1 pathway. Together, these findings uncover a previously unknown role for galanin in the regulation of cardiac autophagy and provide new insights into the molecular mechanisms supporting cell survival in the hypertrophic reprogramming of the heart.
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Affiliation(s)
- Ilenia Martinelli
- National Institute of Health and Medical Research (INSERM) U1048, 31432, Toulouse, Cedex 4, France; Paul Sabatier University, 31062, Toulouse, Cedex 9, France
| | - Andrei Timotin
- National Institute of Health and Medical Research (INSERM) U1048, 31432, Toulouse, Cedex 4, France; Paul Sabatier University, 31062, Toulouse, Cedex 9, France
| | - Paula Moreno-Corchado
- National Institute of Health and Medical Research (INSERM) U1048, 31432, Toulouse, Cedex 4, France; Paul Sabatier University, 31062, Toulouse, Cedex 9, France
| | - Dimitri Marsal
- National Institute of Health and Medical Research (INSERM) U1048, 31432, Toulouse, Cedex 4, France; Paul Sabatier University, 31062, Toulouse, Cedex 9, France
| | - Solomiia Kramar
- National Institute of Health and Medical Research (INSERM) U1048, 31432, Toulouse, Cedex 4, France; Paul Sabatier University, 31062, Toulouse, Cedex 9, France
| | - Halina Loy
- National Institute of Health and Medical Research (INSERM) U1048, 31432, Toulouse, Cedex 4, France; Paul Sabatier University, 31062, Toulouse, Cedex 9, France
| | - Carine Joffre
- Paul Sabatier University, 31062, Toulouse, Cedex 9, France; Centre de Recherches en Cancérologie de Toulouse (CRCT), 2 Avenue Hubert Curien, 31037, Toulouse, France
| | - Frederic Boal
- National Institute of Health and Medical Research (INSERM) U1048, 31432, Toulouse, Cedex 4, France; Paul Sabatier University, 31062, Toulouse, Cedex 9, France
| | - Helene Tronchere
- National Institute of Health and Medical Research (INSERM) U1048, 31432, Toulouse, Cedex 4, France; Paul Sabatier University, 31062, Toulouse, Cedex 9, France
| | - Oksana Kunduzova
- National Institute of Health and Medical Research (INSERM) U1048, 31432, Toulouse, Cedex 4, France; Paul Sabatier University, 31062, Toulouse, Cedex 9, France.
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Aune D, Schlesinger S, Neuenschwander M, Feng T, Janszky I, Norat T, Riboli E. Diabetes mellitus, blood glucose and the risk of heart failure: A systematic review and meta-analysis of prospective studies. Nutr Metab Cardiovasc Dis 2018; 28:1081-1091. [PMID: 30318112 DOI: 10.1016/j.numecd.2018.07.005] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Revised: 07/17/2018] [Accepted: 07/17/2018] [Indexed: 12/21/2022]
Abstract
BACKGROUND AND AIM The strength of the association between diabetes and risk of heart failure has differed between previous studies and the available studies have not been summarized in a meta-analysis. We therefore quantified the association between diabetes and blood glucose and heart failure in a systematic review and meta-analysis. METHODS AND RESULTS PubMed and Embase databases were searched up to May 3rd 2018. Prospective studies on diabetes mellitus or blood glucose and heart failure risk were included. A random effects model was used to calculate summary relative risks (RRs) and 95% confidence intervals (CIs). Seventy seven studies were included. Among the population-based prospective studies, the summary RR for individuals with diabetes vs. no diabetes was 2.06 (95% CIs: 1.73-2.46, I2 = 99.8%, n = 30 studies, 401495 cases, 21416780 participants). The summary RR was 1.23 (95% CI: 1.15-1.32, I2 = 78.2%, n = 10, 5344 cases, 91758 participants) per 20 mg/dl increase in blood glucose and there was evidence of a J-shaped association with nadir around 90 mg/dl and increased risk even within the pre-diabetic blood glucose range. Among the patient-based studies the summary RR was 1.69 (95% CI: 1.57-1.81, I2 = 85.5%, pheterogeneity<0.0001) for diabetes vs. no diabetes (n = 41, 100284 cases and >613925 participants) and 1.25 (95% CI: 0.89-1.75, I2 = 95.6%, pheterogeneity<0.0001) per 20 mg/dl increase in blood glucose (1016 cases, 34309 participants, n = 2). In the analyses of diabetes and heart failure there was low or no heterogeneity among the population-based studies that adjusted for alcohol intake and physical activity and among the patient-based studies there was no heterogeneity among studies with ≥10 years follow-up. CONCLUSIONS These results suggest that individuals with diabetes are at an increased risk of developing heart failure and there is evidence of increased risk even within the pre-diabetic range of blood glucose.
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Affiliation(s)
- D Aune
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom; Department of Nutrition, Bjørknes University College, Oslo, Norway; Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway.
| | - S Schlesinger
- Institute for Biometry and Epidemiology, German Diabetes Center, Leibniz Institute for Diabetes Research at the Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - M Neuenschwander
- Institute for Biometry and Epidemiology, German Diabetes Center, Leibniz Institute for Diabetes Research at the Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - T Feng
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - I Janszky
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway; Regional Center for Health Care Improvement, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - T Norat
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
| | - E Riboli
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
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Risk and predictors of readmission for heart failure following a myocardial infarction between 2004 and 2013: A Swedish nationwide observational study. Int J Cardiol 2017; 248:221-226. [DOI: 10.1016/j.ijcard.2017.05.086] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2016] [Revised: 03/07/2017] [Accepted: 05/20/2017] [Indexed: 11/17/2022]
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Raposeiras-Roubín S, Rodiño-Janeiro BK, Paradela-Dobarro B, Grigorian-Shamagian L, García-Acuña JM, Aguiar-Souto P, Jacquet-Hervet M, Reino-Maceiras MV, Alvarez E, González-Juanatey JR. Predictive value of advanced glycation end products for the development of post-infarction heart failure: a preliminary report. Cardiovasc Diabetol 2012; 11:102. [PMID: 22909322 PMCID: PMC3489693 DOI: 10.1186/1475-2840-11-102] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2012] [Accepted: 08/08/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Since post-infarction heart failure (HF) determines a great morbidity and mortality, and given the physiopathology implications of advanced glycation end products (AGE) in the genesis of myocardial dysfunction, it was intended to analyze the prognostic value of these molecules in order to predict post-infarction HF development. METHODS A prospective clinical study in patients after first acute coronary syndrome was conducted. The follow-up period was consisted in 1 year. In 194 patients consecutively admitted in the coronary unit for myocardial infarct fluorescent AGE levels were measured. The association between glycaemic parameters and the development of post-infarction HF were analyzed in those patients. Finally, we identified the variables with independent predictor value by performing a multivariate analysis of hazard ratio for Cox regression. RESULTS Eleven out of 194 patients (5.6%) developed HF during follow-up (median: 1.0 years [0.8 - 1.5 years]). Even though basal glucose, fructosamine and glycated haemoglobin were significant predictive factors in the univariate analysis, after being adjusted by confounding variables and AGE they lost their statistical signification. Only AGE (Hazard Ratio 1.016, IC 95%: 1.006-1.026; p<0,001), together with NT-proBNP and the infarct extension were predictors for post-infarction HF development, where AGE levels over the median value 5-fold increased the risk of HF development during follow-up. CONCLUSIONS AGE are an independent marker of post-infarction HF development risk.
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Aguilar JC. La insuficiencia cardíaca en el siglo XXI. Epidemiología y consecuencias económicas. CIRUGIA CARDIOVASCULAR 2011. [DOI: 10.1016/s1134-0096(11)70062-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Núñez J, Sanchis J, Núñez E, Bodí V, Mainar L, Miñana G, Merlos P, Palau P, Husser O, Rumiz E, Chorro FJ, Llàcer A. Effect of acute heart failure following discharge in patients with non-ST-elevation acute coronary syndrome on the subsequent risk of death or acute myocardial infarction. Rev Esp Cardiol 2010; 63:1035-1044. [PMID: 20804699 DOI: 10.1016/s1885-5857(10)70207-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
INTRODUCTION AND OBJECTIVES Little is known about how prognosis is influenced by readmission for acute heart failure (AHF) following non-ST-segment elevation acute coronary syndrome (NSTEACS). The aim of this study was to determine the prognostic effect of a first admission for AHF on the risk of acute myocardial infarction (AMI) or death in patients who survived an episode of high-risk NSTEACS. METHODS The study involved 972 consecutive patients with high-risk NSTEACS who survived after hospital admission. Readmission for AHF was selected as the main exposure variable, and its association with subsequent AMI or all-cause death was assessed using Cox proportional hazards models for time-dependent covariates that also included adjustment for competing risks. RESULTS After a median follow-up period of 30 [interquartile range, 12-48] months, 82 patients (8.4%) were admitted for AHF, 146 (15%) had an AMI, and 202 (20.8%) died. The median time to readmission for AHF was 203 [56-336] days after NSTEACS. Patients readmitted for AHF had an increased risk of subsequent death (hazard ratio [HR]=1.67; 95% confidence interval [CI], 1.13-2.45; P=.009) or AMI (HR=2.15; 95% CI, 1.41-3.27; P< .001), which was independent of baseline prognostic and time-dependent variables. CONCLUSIONS Readmission for AHF after high-risk NSTEACS was associated with an increased risk of subsequent death or AMI.
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Affiliation(s)
- Julio Núñez
- Servicio de Cardiología, Hospital Clínico Universitario, Universidad de Valencia, Valencia, España.
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Núñez J, Sanchis J, Núñez E, Bodí V, Mainar L, Miñana G, Merlos P, Palau P, Husser O, Rumiz E, Chorro FJ, Llàcer À. Insuficiencia cardiaca aguda post-alta hospitalaria tras un síndrome coronario agudo sin elevación del segmento-ST y riesgo de muerte e infarto agudo de miocardio subsiguiente. Rev Esp Cardiol 2010. [DOI: 10.1016/s0300-8932(10)70225-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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López de Sá E. Insuficiencia cardíaca tardía postinfarto: encajando las piezas del puzle. Rev Esp Cardiol (Engl Ed) 2005. [DOI: 10.1157/13080951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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