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Pérez de Isla L, Díaz-Díaz JL, Romero MJ, Muñiz-Grijalvo O, Mediavilla JD, Argüeso R, de Andrés R, Fuentes F, Sánchez Muñoz-Torrero JF, Rubio P, Álvarez-Baños P, Mañas D, Suárez Gutierrez L, Saltijeral Cerezo A, Mata P. Characteristics of Coronary Atherosclerosis Related to Plaque Burden Regression During Treatment With Alirocumab: The ARCHITECT Study. Circ Cardiovasc Imaging 2024; 17:e016206. [PMID: 38205656 DOI: 10.1161/circimaging.123.016206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 12/06/2023] [Indexed: 01/12/2024]
Abstract
BACKGROUND Intensive lipid-lowering therapy may induce coronary atherosclerosis regression. Nevertheless, the factors underlying the effect of lipid-lowering therapy on disease regression remain poorly characterized. Our aim was to determine which characteristics of atherosclerotic plaque are associated with a greater reduction in coronary plaque burden (PB) after treatment with alirocumab in patients with familial hypercholesterolemia. METHODS The ARCHITECT study (Effect of Alirocumab on Atherosclerotic Plaque Volume, Architecture and Composition) is a phase IV, open-label, multicenter, single-arm clinical trial to assess the effect of the treatment with alirocumab for 78 weeks on the coronary atherosclerotic PB and its characteristics in subjects with familial hypercholesterolemia without clinical atherosclerotic cardiovascular disease. Participants underwent a coronary computed tomographic angiography at baseline and a final one at 78 weeks. Every patient received alirocumab 150 mg subcutaneously every 14 days in addition to high-intensity statin therapy. RESULTS One hundred and four patients were enrolled. Median age was 53.3 (46.2-59.4) years and 54 were women (51.9%). The global coronary PB changed from 34.6% (32.5%-36.8%) at entry to 30.4% (27.4%-33.4%) at follow-up, which is -4.6% (-7.7% to -1.9%; P<0.001) reduction. A decrease in the percentage of unstable core (fibro-fatty+necrotic plaque; from 14.1 [7.9-22.3] to 8.0 [6.4-10.6]; -6.6%; P<0.001) was found. A greater PB (β, 0.36 [0.13-0.59]; P=0.002) and a higher proportion of unstable core (β, 0.15 [0.08-0.22]; P<0.001) were significantly related to PB regression. CONCLUSIONS Treatment with alirocumab in addition to high-intensity statin therapy might produce a greater PB regression in patients with familial hypercholesterolemia with higher baseline PB and in those with larger unstable core. Further studies are needed to corroborate the hypothesis raised by these results. REGISTRATION URL: https://www.clinicaltrials.gov; Unique identifier: NCT05465278.
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Affiliation(s)
| | - Jose L Díaz-Díaz
- Internal Medicine Department, Hospital Abente y Lago, A Coruña, Spain (J.L.D.-D.)
| | - Manuel J Romero
- Internal Medicine Department, Hospital Infanta Elena, Huelva, Spain (M.J.R.)
| | | | - Juan D Mediavilla
- Internal Medicine Department, Hospital Universitario Virgen de las Nieves, Granada, Spain (J.D.M.)
| | - Rosa Argüeso
- Endocrinology Department, Hospital Universitario Lucus Augusti, Lugo, Spain (R.A.)
| | - Raimundo de Andrés
- Internal Medicine Department, Fundación Jiménez Díaz, Madrid, Spain (R.d.A.)
| | - Francisco Fuentes
- Lipid and Atherosclerosis Unit, CIBERObn, IMBIC, Hospital Universitario Reina Sofia, Córdoba, Spain (F.F.)
| | | | - Patricia Rubio
- Internal Medicine Department, Hospital Universitario Jerez de la Frontera, Spain (P.R.)
| | | | - Dolores Mañas
- Internal Medicine Department, Hospital General Universitario de Ciudad Real, Spain (D.M.)
| | | | | | - Pedro Mata
- Fundación Hipercolesterolemia Familiar, Madrid, Spain (P.M.)
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Sánchez-Bacaicoa C, Santano-Mogena E, Rico-Martín S, Rey-Sánchez P, Juárez-Vela R, Sánchez Muñoz-Torrero JF, López-Espuela F, Calderón-García JF. Association between Asymptomatic Hyperuricemia with Adiposity Indices: A Cross-Sectional Study in a Spanish Population. Nutrients 2023; 15:4798. [PMID: 38004193 PMCID: PMC10675342 DOI: 10.3390/nu15224798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 11/14/2023] [Accepted: 11/14/2023] [Indexed: 11/26/2023] Open
Abstract
INTRODUCTION New anthropometric indices have been developed as an alternative to body mass index (BMI) and waist circumference (WC) to assess body mass and visceral fat. Asymptomatic hyperuricemia is considered an independent cardiovascular risk factor. Currently, little is known about the relationship between asymptomatic hyperuricemia and several new anthropometric indices. This study aimed to assess the association between the presence of asymptomatic hyperuricemia and anthropometric indices, both novel and traditional. METHODS This study analyzed 1094 Spanish subjects who consecutively visited the cardiovascular risk consultation of the University Hospital San Pedro de Alcántara of Cáceres, Spain, between June 2021 and September 2022. Anthropometric measures, including traditional and novel indices, were determined. The asymptomatic hyperuricemia group was defined according to serum uric acid levels. RESULTS All the anthropometric indices studied, including new and traditional, were significantly greater among patients with asymptomatic hyperuricemia, except for WWI. In multiple linear regression analysis, serum uric acid levels were significantly correlated with BMI, WHR, WHtR, AVI, BAI, BRI, CUN-BAE, and WWI but not ABSI or CI. In the univariate analysis, all indices were associated with asymptomatic hyperuricemia (p < 0.05); however, only WHtR (adjusted OR: 2.93; 95% CI: 1.03-8.37; p = 0.044), AVI (adjusted OR: 1.46; 95% CI: 1.04-2.04; p = 0.026), and BRI (adjusted OR: 1.66; 95% CI: 1.19-2.32; p = 0.003) were significantly associated in multivariate analysis. Finally, WHtR, AVI, and BRI provided the largest AUCs. CONCLUSIONS Our findings showed that WHtR, AVI, and BRI were independently positively associated with asymptomatic hyperuricemia and could be good predictors.
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Affiliation(s)
| | - Esperanza Santano-Mogena
- Department of Nursing, Nursing and Occupational Therapy College, University of Extremadura, 10003 Cáceres, Spain; (E.S.-M.); (P.R.-S.); (F.L.-E.); (J.F.C.-G.)
| | - Sergio Rico-Martín
- Department of Nursing, Nursing and Occupational Therapy College, University of Extremadura, 10003 Cáceres, Spain; (E.S.-M.); (P.R.-S.); (F.L.-E.); (J.F.C.-G.)
| | - Purificación Rey-Sánchez
- Department of Nursing, Nursing and Occupational Therapy College, University of Extremadura, 10003 Cáceres, Spain; (E.S.-M.); (P.R.-S.); (F.L.-E.); (J.F.C.-G.)
| | - Raúl Juárez-Vela
- Department of Nursing, Faculty of Health Sciences, University of La Rioja, 26006 Logroño, Spain;
| | | | - Fidel López-Espuela
- Department of Nursing, Nursing and Occupational Therapy College, University of Extremadura, 10003 Cáceres, Spain; (E.S.-M.); (P.R.-S.); (F.L.-E.); (J.F.C.-G.)
| | - Julián F. Calderón-García
- Department of Nursing, Nursing and Occupational Therapy College, University of Extremadura, 10003 Cáceres, Spain; (E.S.-M.); (P.R.-S.); (F.L.-E.); (J.F.C.-G.)
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Costo-Muriel C, Calderón-García JF, Rico-Martín S, Galán-González J, Escudero-Sánchez G, Sánchez-Bacaicoa C, Rodríguez-Velasco FJ, Santano-Mogena E, Fonseca C, Muñoz-Torrero JFS. Relationship between the novel and traditional anthropometric indices and subclinical atherosclerosis evaluated by carotid intima-media thickness (c-IMT). Front Nutr 2023; 10:1170450. [PMID: 37457970 PMCID: PMC10348712 DOI: 10.3389/fnut.2023.1170450] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 06/12/2023] [Indexed: 07/18/2023] Open
Abstract
Introduction Over the last few years, novel anthropometric indices have been developed as an alternative to body mass index (BMI) and other traditional anthropometric measurements to enhance the estimate of fat proportion and its relationship to a future cardiovascular event. The purpose of this study was to investigate the association of carotid intima-media thickness (c-IMT) estimated by Doppler ultrasound with current anthropometric indices (traditional and novel). Methods A cross-sectional study was conducted on a total of 789 Spanish patients. Traditional (BMI, WHR, and WHtR) and new (WWI, AVI, ABSI, BRI, BAI, CUN-BAE, and CI) anthropometric indices were determined, and carotid Doppler ultrasound was performed to evaluate c-IMT (≥0.90 mm). Results Most of the anthropometric indices analyzed were significantly higher among patients with pathological c-IMT, except for BMI, BAI, and CUN-BAE. In multiple linear regression analysis, c-IMT was positively related to ABSI, AVI, BRI, CI, and WWI but not to CUN-BAE, BAI, or traditional anthropometric indices. Similarly, in univariate analysis, all indices were associated with a c-IMT of ≥0.90 mm (p < 0.05), except BMI, BAI, and CUN-BAE; however, only ABSI (adjusted OR: 1.61; 95% CI: 1.08-2.40; p = 0.017), CI (adjusted OR: 1.73; 95% CI: 1.15-2.60; p = 0.008), and WWI (adjusted OR: 1.74; 95% CI: 1.14-2.64; p = 0.009) were significantly associated in multivariate analysis. Finally, CI, ABSI, and WWI provided the largest AUC, and BMI and CUN-BAE showed the lowest AUC. Conclusion ABSI, CI, and WWI were positively associated with pathological c-IMT (≥0.90 mm), independent of other confounders.
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Affiliation(s)
- Clara Costo-Muriel
- Department of Internal Medicine, Hospital Comarcal de la Axarquía, Málaga, Spain
| | - Julián F. Calderón-García
- Department of Nursing, Nursing and Occupational Therapy College, University of Extremadura, Cáceres, Spain
| | - Sergio Rico-Martín
- Department of Nursing, Nursing and Occupational Therapy College, University of Extremadura, Cáceres, Spain
| | | | | | | | | | - Esperanza Santano-Mogena
- Department of Nursing, Nursing and Occupational Therapy College, University of Extremadura, Cáceres, Spain
| | - César Fonseca
- Department of Nursing, University of Évora, Evora, Portugal
- Department of Nursing, Comprehensive Health Research Centre (CHRC), Evora, Portugal
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Pérez de Isla L, Díaz-Díaz JL, Romero MJ, Muñiz-Grijalvo O, Mediavilla JD, Argüeso R, Sánchez Muñoz-Torrero JF, Rubio P, Álvarez-Baños P, Ponte P, Mañas D, Suárez Gutierrez L, Cepeda JM, Casañas M, Fuentes F, Guijarro C, Ángel Barba M, Saltijeral Cerezo A, Padró T, Mata P. Alirocumab and Coronary Atherosclerosis in Asymptomatic Patients with Familial Hypercholesterolemia: The ARCHITECT Study. Circulation 2023; 147:1436-1443. [PMID: 37009731 PMCID: PMC10158600 DOI: 10.1161/circulationaha.122.062557] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Accepted: 03/01/2023] [Indexed: 04/04/2023]
Abstract
BACKGROUND The effect of alirocumab, a PCSK9 (proprotein convertase subtilisin/kexin type 9) inhibitor, on coronary plaque burden in patients with familial hypercholesterolemia has not been addressed. Our aim was to assess changes in coronary plaque burden and its characteristics after treatment with alirocumab by quantification and characterization of atherosclerotic plaque throughout the coronary tree on the basis of a noninvasive analysis of coronary computed tomographic angiography in asymptomatic subjects with familial hypercholesterolemia receiving optimized and stable treatment with maximum tolerated statin dose with or without ezetimibe. METHODS This study is a phase IV, open-label, multicenter, single-arm clinical trial to assess changes in coronary plaque burden and its characteristics after 78 weeks of treatment with alirocumab in patients with familial hypercholesterolemia without clinical atherosclerotic cardiovascular disease. Participants underwent an initial coronary computed tomographic angiography at baseline and another at 78 weeks. Every patient received 150 mg of alirocumab subcutaneiously every 14 days in addition to high-intensity statin therapy. The main outcome was the change on coronary plaque burden and its characteristics by quantification and characterization of atherosclerotic plaque throughout the coronary tree on the basis of analysis of coronary computed tomographic angiography. RESULTS The study was completed by 104 patients. The median age was 53.3 (46.2-59.4) years. Of these patients, 54 were women (51.9%). Median low-density lipoprotein cholesterol was 138.9 (117.5-175.3) mg/dL at entry and 45.0 (36.0-65.0) mg/dL at follow-up (P<0.001). Coronary plaque burden changed from 34.6% (32.5%-36.8%) at entry to 30.4% (27.4%-33.4%) at follow-up (P<0.001). A significant change in the characteristics of the coronary atherosclerosis was also found: an increase in the proportion of calcified (+0.3%; P<0.001) and mainly fibrous (+6.2%; P<0.001) plaque, accompanied by a decrease in the percentage of fibro-fatty (-3.9%; P<0.001) and necrotic plaque (-0.6%; P<0.001). CONCLUSIONS Treatment with alirocumab in addition to high-intensity statin therapy resulted in significant regression of coronary plaque burden and plaque stabilization on coronary computed tomographic angiography over 78 weeks in these groups of patients with familial hypercholesterolemia without clinical atherosclerotic cardiovascular disease. ARCHITECT (Effect of Alirocumab on Atherosclerotic Plaque Volume, Architecture and Composition) could link and explain ODYSSEY OUTCOMES (Evaluation of Cardiovascular Outcomes After an Acute Coronary Syndrome During Treatment With Alirocumab) results. REGISTRATION URL: https://www. CLINICALTRIALS gov; Unique identifier: NCT05465278.
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Affiliation(s)
| | - Jose L. Díaz-Díaz
- Internal Medicine Department, Hospital Abente y Lago, A Coruña, Spain (J.L.E.-D.)
| | - Manuel J. Romero
- Internal Medicine Department, Hospital Infanta Elena, Huelva, Spain M.J.R.)
| | | | - Juan D. Mediavilla
- Internal Medicine Department, Hospital Universitario Virgen de las Nieves, Granada, Spain (J.D.M.)
| | - Rosa Argüeso
- Endocrinology Department, Hospital Universitario Lucus Augusti, Lugo, Spain (R.A.)
| | | | - Patricia Rubio
- Internal Medicine Department, Hospital Universitario Jerez de la Frontera, Spain (P.R.)
| | | | - Paola Ponte
- Internal Medicine Department, Hospital Santa Creu i Sant Pau, Barcelona, Spain (P.P.)
| | - Dolores Mañas
- Internal Medicine Department, Hospital General Universitario de Ciudad Real, Spain (D.M.)
| | | | - José María Cepeda
- Internal Medicine Department, Hospital Comarcal Vega Baja, Orihuela, Alicante, Spain (J.M.C.)
| | - Marta Casañas
- Internal Medicine Department, Hospital San Pedro, Logroño, Spain (M.C.)
| | - Francisco Fuentes
- Lipid and Atherosclerosis Unit, CIBERObn, IMBIC. Hospital Universitario Reina Sofia, Córdoba, Spain (F.F.)
| | - Carlos Guijarro
- Internal Medicine Department, Hospital Universitario Fundación Alcorcón-Universidad Rey Juan Carlos, Madrid, Spain (C.G.)
| | - Miguel Ángel Barba
- Internal Medicine Department, Complejo Hospitalario Universitario, Albacete, Spain (M.A.B.)
| | | | - Teresa Padró
- Programa-ICCC Cardiovascular, Institut de Recerca Hospital Santa Creu i Sant Pau, IIB-Sant Pau, CIBERCV, Barcelona, Spain (T.P.)
| | - Pedro Mata
- Fundación Hipercolesterolemia Familiar, Madrid, Spain (P.M.)
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Costo-Muriel C, Calderón-García JF, Rico-Martín S, Sánchez-Bacaicoa C, Escudero-Sánchez G, Galán-González J, Rodríguez-Velasco FJ, Sánchez Muñoz-Torrero JF. Association of Subclinical Carotid Atherosclerosis Assessed by High-Resolution Ultrasound With Traditional and Novel Anthropometric Indices. Curr Probl Cardiol 2023; 48:101574. [PMID: 36584728 DOI: 10.1016/j.cpcardiol.2022.101574] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Accepted: 12/23/2022] [Indexed: 12/29/2022]
Abstract
Novel anthropometric indices have been proposed as an alternative to body mass index (BMI) and waist circumference (WC) to determine visceral adipose tissue and body mass. Little is known about the relationship of these new anthropometric indices to subclinical carotid atherosclerosis. The objective of this study was to assess the association of anthropometric indices, both new and traditional, with the presence of subclinical carotid artery arteriosclerosis (SCAA) estimated by Doppler ultrasound. This cross-sectional study analyzed 788 Spanish patients who consecutively attended a vascular risk consultation between June 2021 and September 2022. Traditional anthropometric indices (BMI, WHR and WHtR) and novel indices (ABSI, AVI, BAI, BRI, CI, CUNBAE and WWI) were calculated, and Doppler ultrasound in the carotid artery (cIMT and atherosclerosis plaque) was performed to detect SCAA. All analyzed anthropometric indices, except BMI, BAI and CUNBAE, were significantly higher in patients with SCAA. ABSI, BRI, CI, WHR, WHtR and WWI and were associated with SCAA in the univariate analysis (p<0.05); however, only ABSI (adjusted OR: 1.15; 95% CI: 1.10-2.38; p= 0.042) was significantly associated with SCAA in the multivariate analysis. In conclusion, only ABSI was significantly positively associated with SCAA, independent of other confounders.
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Affiliation(s)
- Clara Costo-Muriel
- Department of Internal Medicine, Hospital Comarcal de la AXARQUÍA, Málaga, Spain
| | - Julián F Calderón-García
- Department of Nursing, Nursing and Occupational Therapy College, University of Extremadura, Cáceres, Spain
| | - Sergio Rico-Martín
- Department of Nursing, Nursing and Occupational Therapy College, University of Extremadura, Cáceres, Spain.
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Sánchez-Bacaicoa C, Galán J, Guijarro C, Rico-Martín S, Monreal M, Calderón-García JF, Aguilar-Cortés E, Sánchez Muñoz-Torrero JF. Sustained low-density lipoprotein-cholesterol <70 mg/dl is associated with improved cardiovascular outcomes in the clinical setting. Eur J Clin Invest 2022; 52:e13732. [PMID: 34908162 DOI: 10.1111/eci.13732] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 12/10/2021] [Indexed: 01/14/2023]
Abstract
BACKGROUND AND AIMS Clinical trials have shown that intensive low-density lipoprotein cholesterol (LDL-C) lowering improves cardiovascular outcomes among patients with atherosclerotic cardiovascular disease (ASCVD), but data are limited in real clinical practice, particularly for patients with ASCVD informing different territories. METHODS FRENA was a prospective registry of consecutive outpatients with coronary, cerebrovascular or peripheral artery disease. We compared the incidence of recurrent events in patients with sustained LDL-C levels <70 mg/dl compared with those with ≥70 mg/dl. RESULTS As of December 2018, 1182 patients were eligible for this study. Among them, 172 (14.5%) had mean LDL-C levels ≤70 mg/dl, and 1010 (85.5%) had <70 mg/dl. Their clinical characteristics at baseline were similar. During 5 years of follow-up, 252 patients (21%) suffered major adverse cardiovascular events (MACE). The incidence rates of MACE were 3.42 events per 100 patient-years (95% confidence interval [95% CI] 2.17-5.14) in patients with levels <70 mg/dl and 5.57 (95% CI, 4.87-6.34) in those with ≥70 mg/dl; the rate ratio was 0.61 (95% CI, 0.39-0.92), p = 0.019. On multivariable analysis, patients with LDL-C levels <70 mg/dl were at lower risk for MACE (hazard ratio [HR]: 0.61 [95% CI, 0.39-0.93] p < 0.05). MACE reduction was driven by a decrease in coronary and peripheral events with no significant effect on stroke. CONCLUSIONS Long-term sustained LDL-C <70 mg/dl in the clinical practice is associated with reduction in cardiovascular and peripheral vascular events with no apparent effect on stroke.
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Affiliation(s)
| | - Javier Galán
- Department of Internal Medicine, Hospital San Pedro Alcántara, Cáceres, Spain
| | - Carlos Guijarro
- Department of Medical Specialties and Public Heatlh, Alcorcon University Hospital. Rey Juan Carlos University, Madrid, Spain
| | - Sergio Rico-Martín
- Department of Nursing, Nursing and Occupational Therapy College, University of Extremadura, Cáceres, Spain
| | - Manuel Monreal
- Department of Internal Medicine, Hospital Germans Trias i Pujol, Badalona, Spain
| | - Julián F Calderón-García
- Department of Nursing, Nursing and Occupational Therapy College, University of Extremadura, Cáceres, Spain
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Calderón-García JF, Roncero-Martín R, Rico-Martín S, De Nicolás-Jiménez JM, López-Espuela F, Santano-Mogena E, Alfageme-García P, Sánchez Muñoz-Torrero JF. Effectiveness of Body Roundness Index (BRI) and a Body Shape Index (ABSI) in Predicting Hypertension: A Systematic Review and Meta-Analysis of Observational Studies. Int J Environ Res Public Health 2021; 18:ijerph182111607. [PMID: 34770120 PMCID: PMC8582804 DOI: 10.3390/ijerph182111607] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 10/29/2021] [Accepted: 11/01/2021] [Indexed: 01/18/2023]
Abstract
Introduction: The body roundness index (BRI) and a body shape index (ABSI) are novel anthropometric indices established to determine both the amount visceral adipose tissue and body fat. Objective: to investigate whether BRI and ABSI are better predictors of hypertension than body mass index (BMI), waist circumference (WC) or waist-to-height ratio (WHtR). Methods: A systematic search was conducted in the Scopus, PubMed and Web of Science databases up until 31 December 2020. Results: The estimated pooled area under curve [AUC (95% CI)] for BRI [0.67 (0.65–0.70)] for the prediction of hypertension were superior to that of ABSI (0.58 (0.56–0.60)), similar to that of BMI [0.67 (0.64–0.69)], and lower than those WC [0.68 (0.66–0.70)] and WHtR [0.68 (0.66–0.71)]. Nevertheless, the difference of BRI compared to WC and WHtR in the context of predicting hypertension was non-significant. ABSI was significantly lower (p < 0.05) than BRI, BMI, WC and WHtR. Similar findings were observed with the summary receiver operating characteristic curve (AUC-SROC). There were no significant differences between subgroups according to type of population or diagnostic criteria of hypertension. The diagnostic odds ratio (dORs) proved that increased BRI and ABSI were related with an elevated hypertension risk. Conclusions: BRI and ABSI have discriminatory power for hypertension in adult women and men from different populations. Although, WHtR and WC provided the best performance when assessing hypertension, no significant differences were found for BRI. Finally, BRI was significantly better predictor of hypertension than ABSI.
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Affiliation(s)
- Julián F. Calderón-García
- Department of Nursing, Nursing and Occupational Therapy College, University of Extremadura, 10003 Cáceres, Spain; (J.F.C.-G.); (R.R.-M.); (F.L.-E.); (E.S.-M.)
| | - Raúl Roncero-Martín
- Department of Nursing, Nursing and Occupational Therapy College, University of Extremadura, 10003 Cáceres, Spain; (J.F.C.-G.); (R.R.-M.); (F.L.-E.); (E.S.-M.)
| | - Sergio Rico-Martín
- Department of Nursing, Nursing and Occupational Therapy College, University of Extremadura, 10003 Cáceres, Spain; (J.F.C.-G.); (R.R.-M.); (F.L.-E.); (E.S.-M.)
- Correspondence: ; Tel.: +34-927251267
| | - Jorge M. De Nicolás-Jiménez
- Department of Public Health, Centro de Salud Zona Centro de Cáceres, Servicio Extremeño de Salud, 10001 Cáceres, Spain;
| | - Fidel López-Espuela
- Department of Nursing, Nursing and Occupational Therapy College, University of Extremadura, 10003 Cáceres, Spain; (J.F.C.-G.); (R.R.-M.); (F.L.-E.); (E.S.-M.)
| | - Esperanza Santano-Mogena
- Department of Nursing, Nursing and Occupational Therapy College, University of Extremadura, 10003 Cáceres, Spain; (J.F.C.-G.); (R.R.-M.); (F.L.-E.); (E.S.-M.)
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Sánchez Muñoz-Torrero JF, Escudero-Sánchez G, Calderón-García JF, Rico-Martín S, Robles NR, Bacaicoa MA, Alcalá-Pedrajas JN, Gil-Fernández G, Monreal M. Systolic Blood Pressure and Outcomes in Stable Outpatients with Recent Symptomatic Artery Disease: A Population-Based Longitudinal Study. Int J Environ Res Public Health 2021; 18:ijerph18179348. [PMID: 34501937 PMCID: PMC8431050 DOI: 10.3390/ijerph18179348] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 08/24/2021] [Accepted: 08/30/2021] [Indexed: 12/17/2022]
Abstract
Objectives: The most appropriate targets for systolic blood pressure (SBP) levels to reduce cardiovascular morbidity and mortality in patients with symptomatic artery disease remain controversial. We compared the rate of subsequent ischemic events or death according to mean SBP levels during follow-up. Design: Prospective cohort study. FRENA is an ongoing registry of stable outpatients with symptomatic coronary (CAD), cerebrovascular (CVD) or peripheral artery disease (PAD). Setting: 24 Spanish hospitals. Participants: 4789 stable outpatients with vascular disease. Results: As of June 2017, 4789 patients had been enrolled in different Spanish centres. Of these, 1722 (36%) had CAD, 1383 (29%) CVD and 1684 (35%) PAD. Over a mean follow-up of 18 months, 136 patients suffered subsequent myocardial infarction, 125 had ischemic stroke, 74 underwent limb amputation, and 260 died. On multivariable analysis, CVD patients with mean SBP levels 130–140 mm Hg had a lower risk of mortality than those with levels <130 mm Hg (hazard ratio (HR): 0.39; 95% CI: 0.20–0.77), as did those with levels >140 mm Hg (HR: 0.46; 95% CI: 0.26–0.84). PAD patients with mean SBP levels >140 mm Hg had a lower risk for subsequent ischemic events (HR: 0.57; 95% CI: 0.39–0.83) and those with levels 130–140 mm Hg (HR: 0.47; 95% CI: 0.29–0.78) or >140 mm Hg (HR: 0.32; 95% CI: 0.21–0.50) had a lower risk of mortality. We found no differences in patients with CAD. Conclusions: In this real-world cohort of symptomatic arterial disease patients, most of whom are not eligible for clinical trials, the risk of subsequent events and death varies according to the levels of SBP and the location of previous events. Especially among patients with large artery atherosclerosis, PAD or CVD, SBP <130 mm Hg may result in increased mortality. Due to potential factors in this issue, Prospective, well designed studies are warranted to confirm these observational data.
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Affiliation(s)
| | | | - Julián F. Calderón-García
- Department of Nursing, Nursing and Occupational Therapy College, University of Extremadura, 10003 Cáceres, Spain;
| | - Sergio Rico-Martín
- Department of Nursing, Nursing and Occupational Therapy College, University of Extremadura, 10003 Cáceres, Spain;
- Correspondence:
| | | | | | - José N. Alcalá-Pedrajas
- Department of Internal Medicine, Hospital Comarcal Valle de los Pedroches, 14400 Pozoblanco, Spain;
| | - Guadalupe Gil-Fernández
- Department of Nursing, Faculty of Medicine, University of Extremadura, 06080 Badajoz, Spain;
| | - Manuel Monreal
- Department of Internal Medicine, Hospital Germans Trias i Pujol, Badalona, 08916 Barcelona, Spain;
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9
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Galán-González J, Rico-Martín S, Calderón-García JF, Antón J, Ramírez-Moreno JM, Álvarez-Rodríguez LR, Sánchez Muñoz-Torrero JF. Location of recurrent cardiovascular events and anticardiolipin antibodies. Eur J Clin Invest 2021; 51:e13533. [PMID: 33666941 DOI: 10.1111/eci.13533] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 02/22/2021] [Accepted: 02/23/2021] [Indexed: 12/27/2022]
Abstract
BACKGROUND The relationship between anticardiolipin (aCL) antibodies and cardiovascular events is uncertain and may vary according to arterial location. MATERIALS AND METHODS FRENA is an ongoing registry of stable outpatients with symptomatic coronary artery disease (CAD), cerebrovascular disease (CVD) or peripheral artery disease (PAD). The rate of subsequent ischaemic events was cross-referenced with the presence of aCL antibodies (any isotype, IgG or IgM). RESULTS As of June 2017, 1387 stable outpatients were recruited. Of these, 120 (8.7%) showed positive levels of aCL antibodies. Over an average follow-up of 18 months, 250 patients developed subsequent events: 101 myocardial infarction, 57 ischaemic stroke and 92 critical leg events. Patients with positive aCL antibodies had a higher risk of distal artery events (a composite of ischaemic stroke or critical leg events) than patients with undetectable or low levels (rate ratio: 1.66; 95% CI: 1.07-2.60). However, an association with central coronary events was not found. The multivariate Cox analysis after adjustment for relevant clinical covariates showed that positivity of aCL antibodies is an independent risk factor for distal events (hazard ratio: 1.60; 95% CI: 1.01-2.55; P < .05). CONCLUSIONS Positivity of aCL antibodies is associated with an increased risk of subsequent distal artery ischaemic events (cerebral or leg arteries) but not coronary artery events. Anticardiolipin antibodies appear to have a different relationship on the localisation of ischaemic events in patients with symptomatic artery disease.
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Affiliation(s)
| | - Sergio Rico-Martín
- Department of Nursing, Nursing and Occupational Therapy College, University of Extremadura, Cáceres, Spain
| | - Julián F Calderón-García
- Department of Nursing, Nursing and Occupational Therapy College, University of Extremadura, Cáceres, Spain
| | - Joaquín Antón
- Department of Internal Medicine, Hospital San Pedro Alcántara, Cáceres, Spain
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Rico Martín S, Vassilenko V, de Nicolás Jiménez JM, Rey Sánchez P, Serrano A, Martínez Alvarez M, Calderón García JF, Sánchez Muñoz-Torrero JF. Cardio-ankle vascular index (CAVI) measured by a new device: protocol for a validation study. BMJ Open 2020; 10:e038581. [PMID: 33082193 PMCID: PMC7577065 DOI: 10.1136/bmjopen-2020-038581] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 09/14/2020] [Accepted: 09/22/2020] [Indexed: 01/10/2023] Open
Abstract
INTRODUCTION Cardio-ankle vascular index (CAVI) is a new marker of arterial stiffness (AS) that can assess vascular wall stiffness in the aorta, femoral artery and tibial artery. CAVI is less affected by blood pressure at the time of measurement than the gold standard method (carotid-femoral pulse wave velocity (PWV)). Our group has developed a device called VOPITB (Velocidad Onda de Pulso Índice Tobillo Brazo) that uses the oscillometric method and easily and accurately measures the PWV in the arms and legs separately, allowing new AS indices to be studied. This article describes the research protocol to determine CAVI using VOPITB and to validate the device against a reference device (VaSera VS-1500) and assess its clinical utility. METHODS AND ANALYSES A cross-sectional, descriptive and observational study will be conducted. In all, 120 subjects (a minimum of 40% of subjects from any one gender) will be evaluated. CAVI will be determined from the measurement by VOPITB and VaSera VS-1500. For each subject, the average of the three readings taken with each device will be calculated. The Bland-Altman plot will be used to determine whether any bias exists in the data-that is, a tendency of the size of the difference to vary with the mean. The participants will be divided roughly equally between the following age bands: <30, 30-60 and >60 years. ETHICS AND DISSEMINATION The study has been approved by the ethics committee of the Hospital San Pedro de Alcántara, Cáceres, Spain. The participants will be required to sign an informed consent form before inclusion in the study, in accordance with the Declaration of Helsinki and WHO standards for observational studies. The dissemination plan of the research study results will be through presentations in relevant national and international conferences and scientific publications in peer-reviewed journals. TRIAL REGISTRATION NUMBER NCT04303546.
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Affiliation(s)
- Sergio Rico Martín
- Department of Nursing, Nursing and Occupational Therapy College. Universidad de Extremadura, Caceres, Spain
- Iberian Network on Arterial Structure, Central Hemodynamics and Neurocognition, Caceres, Spain
| | - Valentina Vassilenko
- Iberian Network on Arterial Structure, Central Hemodynamics and Neurocognition, Caceres, Spain
- Laboratory of Instrumentation, Biomedical Engineering and Radiation Physics (LIBPhys-UNL), NOVA School of Science and Technology, NOVA University Lisbon, Caprica, Portugal
| | - Jorge M de Nicolás Jiménez
- Iberian Network on Arterial Structure, Central Hemodynamics and Neurocognition, Caceres, Spain
- Zona Centro Health Center, Extremadura Health Service, Cáceres, Spain
| | - Purificación Rey Sánchez
- Department of Nursing, Nursing and Occupational Therapy College. Universidad de Extremadura, Caceres, Spain
| | - Andreia Serrano
- Iberian Network on Arterial Structure, Central Hemodynamics and Neurocognition, Caceres, Spain
- Laboratory of Instrumentation, Biomedical Engineering and Radiation Physics (LIBPhys-UNL), NOVA School of Science and Technology, NOVA University Lisbon, Caprica, Portugal
| | | | - Julián F Calderón García
- Department of Nursing, Nursing and Occupational Therapy College. Universidad de Extremadura, Caceres, Spain
- Iberian Network on Arterial Structure, Central Hemodynamics and Neurocognition, Caceres, Spain
| | - Juan F Sánchez Muñoz-Torrero
- Iberian Network on Arterial Structure, Central Hemodynamics and Neurocognition, Caceres, Spain
- Department of Internal Medicine, Hospital San Pedro de Alcantara, Caceres, Spain
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Pérez de Isla L, Arroyo-Olivares R, Alonso R, Muñiz-Grijalvo O, Díaz-Díaz JL, Zambón D, Fuentes F, Mata N, Piedecausa M, Mañas MD, Sánchez Muñoz-Torrero JF, Miramontes-González JP, de Andrés R, Mauri M, Aguado R, Brea Á, Cepeda JM, Vidal-Pardo JI, Martínez-Faedo C, Barba MÁ, Argüeso R, Ruiz-Pérez E, Michán A, Arrieta F, Riestra Fernández M, Pérez L, Pinilla JM, Díaz-Soto G, Pintó X, Padró T, Badimón L, Mata P, Aguado R, Perez-Corral B, Almagro F, Alonso R, Arroyo R, Mata N, Mata P, Isla LPD, Saltijeral A, Arrieta F, Badimón L, Padró T, Barba MÁ, Brea Á, Mosquera D, Casañas M, Carbayo J, Cepeda JM, De Andrés R, Díaz JL, Díaz-Soto G, Diéguez M, Riestra M, Fuentes F, López-Miranda J, Galiana J, Mañas MD, García-Cruces J, Garrido JA, Irigoyen L, Martínez PL, Martínez-Faedo C, Suárez L, Mauri M, Borrallo RM, Mediavilla JD, Jaén F, González P, Michán A, Rubio P, Miramontes P, Morera JL, Muñiz O, González A, Pereyra F, Pérez L, Piedecausa M, Pastor J, Pinilla JM, Pintó X, Romero MJ, Ruiz E, Álvarez MP, Sáenz P, Sánchez JF, Sanz C, Vidal JI, Argüeso R, Zambón D. Incidencia de eventos cardiovasculares y cambios en el riesgo estimado y en el tratamiento de la hipercolesterolemia familiar: registro SAFEHEART. Rev Esp Cardiol 2020. [DOI: 10.1016/j.recesp.2019.10.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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12
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Pérez de Isla L, Arroyo-Olivares R, Alonso R, Muñiz-Grijalvo O, Díaz-Díaz JL, Zambón D, Fuentes F, Mata N, Piedecausa M, Mañas MD, Sánchez Muñoz-Torrero JF, Miramontes-González JP, de Andrés R, Mauri M, Aguado R, Brea Á, Cepeda JM, Vidal-Pardo JI, Martínez-Faedo C, Barba MÁ, Argüeso R, Ruiz-Pérez E, Michán A, Arrieta F, Riestra Fernández M, Pérez L, Pinilla JM, Díaz-Soto G, Pintó X, Padró T, Badimón L, Mata P. Incidence of cardiovascular events and changes in the estimated risk and treatment of familial hypercholesterolemia: the SAFEHEART registry. Rev Esp Cardiol (Engl Ed) 2020; 73:828-834. [PMID: 32201274 DOI: 10.1016/j.rec.2019.10.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 10/21/2019] [Indexed: 06/10/2023]
Abstract
INTRODUCTION AND OBJECTIVES The SAFEHEART study was designed to analyze the situation of familial heterozygous hypercholesterolemia (FHH) and improve knowledge of this disease in Spain. Our objective was to determine the incidence rate of cardiovascular events, the estimated risk of developing an event and its modification, the use of lipid-lowering treatment, and the achievement of low-density lipoprotein cholesterol targets in patients with FHH. METHODS SAFEHEART is a prospective, open, multicenter, nationwide cohort study, with long-term protocol-based follow-up in a population of individuals with molecularly-characterized FHH. We analyzed patients older than 18 years with complete follow-up. RESULTS We included 2648 patients with FHH. The median follow-up was 6.6 (4.8-9.7) years. The overall incidence rate of cardiovascular events was 1.3 events/100 patient-years. After the follow-up, the 10-year estimated risk of developing a cardiovascular event was reduced from 1.6% to 1.3% (P <.001). In the last follow-up, 20.6% and 22.2% of the patients in primary and secondary prevention achieved low-density lipoprotein cholesterol values <100mg/dL and <70mg/dL, respectively. CONCLUSIONS This study was performed in the largest population of patients with FHH in Spain. We identified the incidence rate of cardiovascular events, the estimated risk of developing a cardiovascular event and its modification, the achievement of low-density lipoprotein cholesterol targets, and the therapeutic management in this population. Although the cardiovascular risk of FHH is high, appropriate treatment reduces the likelihood of an event. CLINICAL TRIAL REGISTRATION http://www.clinicaltrials.gov. Identifier: NCT02693548.
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Affiliation(s)
- Leopoldo Pérez de Isla
- Servicio de Cardiología, Hospital Clínico San Carlos, IDISSC, Madrid, Spain; Fundación Hipercolesterolemia Familiar, Madrid, Spain.
| | | | - Rodrigo Alonso
- Fundación Hipercolesterolemia Familiar, Madrid, Spain; Departamento de Nutrición, Clínica Las Condes, Santiago de Chile, Chile
| | | | | | - Daniel Zambón
- Servicio de Endocrinología, Hospital Clínico de Barcelona, Barcelona, Spain
| | - Francisco Fuentes
- Unidad de Lípidos y Arteriosclerosis, IMIBIC, Hospital Universitario Reina Sofía, Córdoba, Spain
| | - Nelva Mata
- Departamento de Epidemiología, Consejería de Sanidad, Madrid, Spain
| | - Mar Piedecausa
- Servicio de Medicina Interna, Hospital de Elche, Elche, Alicante, Spain
| | - M Dolores Mañas
- Servicio de Medicina Interna, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain
| | | | | | | | - Marta Mauri
- Servicio de Medicina Interna, Hospital de Terrassa, Terrassa, Barcelona, Spain
| | - Rocío Aguado
- Servicio de Endocrinología, Hospital Universitario de León, León, Spain
| | - Ángel Brea
- Servicio de Medicina Interna, Hospital San Pedro, Logroño, Spain
| | - José M Cepeda
- Servicio de Medicina Interna, Hospital Comarcal Vega Baja, Orihuela, Alicante, Spain
| | | | | | - Miguel Ángel Barba
- Servicio de Medicina Interna, Hospital General de Albacete, Albacete, Spain
| | - Rosa Argüeso
- Servicio de Endocrinología, Hospital Lucus Augusti, Lugo, Spain
| | - Enrique Ruiz-Pérez
- Servicio de Endocrinología, Hospital Universitario de Burgos, Burgos, Spain
| | - Alfredo Michán
- Servicio de Medicina Interna, Hospital de Jerez de la Frontera, Cádiz, Spain
| | | | | | - Leire Pérez
- Servicio de Endocrinología, Hospital Universitario de Álava, Vitoria, Spain
| | | | - Gonzalo Díaz-Soto
- Servicio de Endocrinología, Hospital Clínico Universitario, Valladolid, Spain
| | - Xavier Pintó
- Servicio de Medicina Interna, Hospital de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Teresa Padró
- Institut de Recerca del Hospital de la Santa Creu i Sant Pau, IIB Sant Pau, Barcelona, Spain
| | - Lina Badimón
- Institut de Recerca del Hospital de la Santa Creu i Sant Pau, IIB Sant Pau, Barcelona, Spain
| | - Pedro Mata
- Fundación Hipercolesterolemia Familiar, Madrid, Spain
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Rico-Martín S, Calderón-García JF, Sánchez-Rey P, Franco-Antonio C, Martínez Alvarez M, Sánchez Muñoz-Torrero JF. Effectiveness of body roundness index in predicting metabolic syndrome: A systematic review and meta-analysis. Obes Rev 2020; 21:e13023. [PMID: 32267621 DOI: 10.1111/obr.13023] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Revised: 03/07/2020] [Accepted: 03/08/2020] [Indexed: 01/02/2023]
Abstract
Body roundness index (BRI) is a new anthropometric index developed to predict both body fat and the percentage of visceral adipose tissue. Our aim was to investigate whether BRI is superior to traditional anthropometric indices in predicting metabolic syndrome (MetS). This systematic review and meta-analysis was conducted using Pubmed, Scopus and Web of Sciences databases. The estimated pooled areas under curve (AUCs) for BRI predicting MetS was higher than body mass index (BMI), waist-to-hip ratio (WHR), body shape index (ABSI) and body adiposity index (BAI), similar to waist circumference (WC) and lower than waist-to-height ratio (WHtR). However, the difference between BRI and BMI, WC and WHtR predicting MetS was statistically non-significant. Similar results were found with the summary receiver operating characteristic curve (AUC-SROC). In addition, the non-Chinese population had pooled AUCs greater than the Chinese population for all indices. Pooled ORs showed that BRI is associated with an increased MetS risk. In conclusion, BRI had good discriminatory power for MetS in adults of both sexes from diverse populations (AUC > 0.7; AUC-SROC>0.7). However, WC and WHtR offer the best performance when screening for MetS, and non-significant differences were found with BRI. In contrast, BRI was superior to BMI, WHR, ABSI and BAI in predicting MetS.
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Affiliation(s)
- Sergio Rico-Martín
- Department of Nursing, Nursing and Occupational Therapy College, University of Extremadura, Cáceres, Spain
| | - Julían F Calderón-García
- Department of Nursing, Nursing and Occupational Therapy College, University of Extremadura, Cáceres, Spain
| | - Purificación Sánchez-Rey
- Department of Nursing, Nursing and Occupational Therapy College, University of Extremadura, Cáceres, Spain
| | - Cristina Franco-Antonio
- Department of Nursing, Nursing and Occupational Therapy College, University of Extremadura, Cáceres, Spain
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Muñoz-Torrero JFS, Zamorano J, Rico-Martín S, Rivas MD, Bacaicoa MA, Robles R, Sanchez-Bacaicoa C, Monreal M. Proton pump inhibitors and risk for recurrent ischemic events or death in outpatients with symptomatic artery disease. Atherosclerosis 2020; 292:84-89. [DOI: 10.1016/j.atherosclerosis.2019.11.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 10/01/2019] [Accepted: 11/12/2019] [Indexed: 02/08/2023]
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Coll-Fernández R, Coll R, Muñoz-Torrero JFS, Aguilar E, Ramón Álvarez L, Sahuquillo JC, Yeste M, Jiménez PE, Mujal A, Monreal M. Supervised versus non-supervised exercise in patients with recent myocardial infarction: A propensity analysis. Eur J Prev Cardiol 2015; 23:245-52. [DOI: 10.1177/2047487315578443] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2014] [Accepted: 03/02/2015] [Indexed: 11/15/2022]
Affiliation(s)
- Roser Coll-Fernández
- Department of Physical Medicine and Rehabilitation, Hospital Universitari Parc Taulí Sabadell, Spain
- Universitat Autònoma de Barcelona, Spain
| | - Ramon Coll
- Department of Physical Medicine and Rehabilitation, Hospital Universitari Germans Trias i Pujol, Spain
| | | | | | - Lorenzo Ramón Álvarez
- Universitat Autònoma de Barcelona, Spain
- Department of Angiology and Vascular Surgery, Hospital de Terrassa, Spain
| | | | - Montserrat Yeste
- Department of Angiology and Vascular Surgery, Hospital de Terrassa, Spain
| | | | - Abel Mujal
- Department of Internal Medicine, Hospital Universitari Parc Taulí Sabadell, Spain
| | - Manuel Monreal
- Universitat Autònoma de Barcelona, Spain
- Department of Internal Medicine, Hospital Universitari Germans Trias i Pujol, Spain
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Sánchez Muñoz-Torrero JF, Rivas MD, Zamorano J, Alonso R, Joya-Vazquez P, Padró T, Mata P. rs1801275 Interleukin-4 receptor alpha polymorphism in familial hypercholesterolemia. J Clin Lipidol 2014; 8:418-22. [DOI: 10.1016/j.jacl.2014.04.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2013] [Revised: 03/08/2014] [Accepted: 04/20/2014] [Indexed: 10/25/2022]
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Vega J, Romaní S, Garcipérez FJ, Vicente L, Pacheco N, Zamorano J, Gómez-Barrado JJ, Sánchez Muñoz-Torrero JF. [Peripheral arterial disease: efficacy of the oscillometric method]. Rev Esp Cardiol 2011; 64:619-21. [PMID: 21435772 DOI: 10.1016/j.recesp.2010.10.019] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2010] [Accepted: 10/14/2010] [Indexed: 11/25/2022]
Abstract
Relatively little is known on how the Doppler method compares with oscillometric measurement using a conventional automatic blood pressure device to determine the ankle-brachial index, when determinations are performed by physicians with little experience. To assess the diagnostic efficacy of both methods in this professional group, we calculated their sensitivity, specificity, and positive and negative predictive value in 158 legs of 85 patients with symptoms of intermittent claudication. Angiography was used as the gold standard. Of the legs examined, 131 showed significant arterial obstruction. The oscillometric method showed 97% sensitivity, 89% specificity, 98% positive predictive value, and 86% negative predictive value. The Doppler method showed 95% sensitivity, 56% specificity, 91% positive predictive value, and 68% negative predictive value. This study suggests that the automatic blood pressure equipment has greater diagnostic accuracy when the test is performed by physicians not specifically trained to use the Doppler probe. Full English text available from: www.revespcardiol.org.
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Affiliation(s)
- Jorge Vega
- Servicio de Cardiología, Hospital San Pedro de Alcántara, Cáceres, Spain.
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Camafort M, Alvarez-Rodríguez LR, Muñoz-Torrero JFS, Sahuquillo JC, López-Jiménez L, Coll R, Monreal M. Glucose control and outcome in patients with stable diabetes and previous coronary, cerebrovascular or peripheral artery disease. Findings from the FRENA Registry. Diabet Med 2011; 28:73-80. [PMID: 21166848 DOI: 10.1111/j.1464-5491.2010.03153.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
AIM The aim of this study was to address the controversy over the influence of intensive glucose control on the risk for cardiovascular events in patients with Type 2 diabetes. METHODS FRENA is an ongoing registry of stable outpatients with symptomatic coronary artery disease, cerebrovascular disease or peripheral artery disease. We compared the incidence of subsequent ischaemic events (myocardial infarction, stroke or critical limb ischaemia) in patients with Type 2 diabetes and mean HbA(1c) levels < 7.0% (< 53 mmol/mol) vs. those with HbA(1c) levels > 7.0% (> 53 mmol/mol). RESULTS Of 974 patients with Type 2 diabetes, 480 (49%) had mean HbA(1c) levels < 7% (< 53 mmol/mol). Over a mean follow-up of 14 months, 126 patients (13%) had subsequent ischaemic events: myocardial infarction (43), stroke (29) and critical limb ischaemia (64). The incidence of subsequent ischaemic events was significantly lower in patients with mean HbA(1c) levels < 7.0% (< 53 mmol/mol) than in those with HbA(1c) levels > 7.0% (> 53 mmol/mol) (8.6 vs. 14 per 100 patient-years; rate ratio 0.6; 95% CI 0.4-0.9). These differences persisted after adjusting for potential confounders. However, this better outcome was only found in patients presenting with coronary artery disease (rate ratio 0.4; 95% CI 0.2-0.8), not in those with cerebrovascular disease (rate ratio 0.9; 95% CI 0.4-2.0) or peripheral artery disease (rate ratio 0.8; 95% CI 0.5-1.3). Patients with mean HbA(1c) levels < 7.0% (< 53 mmol/mol) also had a lower mortality (rate ratio 0.6; 95% CI 0.3-0.99). CONCLUSIONS In secondary prevention, patients with diabetes and HbA(1c) levels < 7.0% (< 53 mmol/mol) had a lower incidence of subsequent ischaemic events and a lower mortality than those with HbA(1c) levels > 7.0% (> 53 mmol/mol). These differences appeared only in patients with coronary artery disease.
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Affiliation(s)
- M Camafort
- Department of Internal Medicine, Health Research Institute, Pere Virgili, Hospital Comarcal Mora d'Ebre, Tarragona, Spain
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Sánchez Muñoz-Torrero JF. Apneas obstructivas del sueño y arterioesclerosis. Rev Neurol 2005. [DOI: 10.33588/rn.41s03.2005422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Sánchez Muñoz-Torrero JF, Luengo Álvarez J, Casado Naranjo I, Ramírez Moreno JM, Ruiz Llano F, Costo Campoamor A. Encefalitis herpética en Cáceres. Análisis de los últimos cinco años. Rev Neurol 2005. [DOI: 10.33588/rn.4009.2004454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Sánchez Muñoz-Torrero JF, Crespo L, Chiquero M. Fiebre facticia. Med Clin (Barc) 2004. [DOI: 10.1157/13059026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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