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Anguita-Gámez M, Vivas D, Ferrandis R, Esteve-Pastor MA, Marín F, Anguita Sánchez M. Periprocedural use of antithrombotic therapy in interventional cardiology in Spain: are we doing better than other specialties? Rev Esp Cardiol (Engl Ed) 2024:S1885-5857(24)00108-7. [PMID: 38580142 DOI: 10.1016/j.rec.2024.02.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 02/19/2024] [Indexed: 04/07/2024]
Affiliation(s)
| | - David Vivas
- Instituto Cardiovascular, Hospital Clínico San Carlos, Madrid, Spain; Departamento de Medicina, Facultad de Medicina, Universidad Complutense, Madrid, Spain
| | - Raquel Ferrandis
- Servicio de Anestesiología, Reanimación y Terapéutica del Dolor, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - María Asunción Esteve-Pastor
- Servicio de Cardiología, Hospital Clínico Universitario Virgen de la Arrixaca, Universidad de Murcia, Instituto Murciano de Investigación Biosanitaria (IMIB)-Arrixaca, El Palmar, Murcia, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain
| | - Francisco Marín
- Servicio de Cardiología, Hospital Clínico Universitario Virgen de la Arrixaca, Universidad de Murcia, Instituto Murciano de Investigación Biosanitaria (IMIB)-Arrixaca, El Palmar, Murcia, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain
| | - Manuel Anguita Sánchez
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Unidad de Gestión Clínica (UGC) de Cardiología, Hospital Universitario Reina Sofía, Instituto Maimónides para la Investigación Biomédica de Córdoba (IMIBIC), Universidad de Córdoba, Córdoba, Spain.
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Anguita Sánchez M, Recio Mayoral A, Rodríguez Padial L. Improving the quality of healthcare. Results of the SEC-Excelente accreditation program in heart failure of the Spanish Society of Cardiology. Rev Esp Cardiol (Engl Ed) 2024:S1885-5857(24)00100-2. [PMID: 38521437 DOI: 10.1016/j.rec.2024.02.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 02/05/2024] [Indexed: 03/25/2024]
Affiliation(s)
- Manuel Anguita Sánchez
- Unidad de Gestión Clínica de Cardiología, Hospital Universitario Reina Sofía, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Universidad de Córdoba, Córdoba, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain.
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Rodríguez-Padial L, Pérez A, Anguita Sánchez M, Barrios V, Gimeno-Orna JA, Muñiz J. Characteristics of women with type 2 diabetes and heart failure in Spain. The DIABET-IC study. Cardiol J 2023; 31:103-110. [PMID: 36896635 PMCID: PMC10919575 DOI: 10.5603/cj.a2023.0016] [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] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Revised: 12/04/2022] [Accepted: 01/31/2023] [Indexed: 03/11/2023] Open
Abstract
BACKGROUND Heart failure (HF) is the second most common initial presentation of cardiovascular disease in people with type 2 diabetes mellitus (T2DM). T2DM carries an increased risk of HF in women. The aim of this study is to analyze the clinical characteristics and the treatment received by women with HF and T2DM in Spain. METHODS The DIABET-IC study included 1517 patients with T2DM in 2018-2019 in Spain, in 30 centers, which included the first 20 patients with T2DM seen in cardiology and endocrinology clinics. They underwent clinical evaluation, echocardiography, and analysis, with a 3-year follow-up. Baseline data are presented in this study. RESULTS 1517 patients were included (501 women; aged 67.28 ± 10.06 years). Women were older (68.81 ± 9.90 vs. 66.53 ± 10.06 years; p < 0.001) and had a lower frequency of a history of coronary disease. There was a history of HF in 554 patients, which was more frequent in women (38.04% vs. 32.86%; p < 0.001), and preserved ejection fraction being more frequent in them (16.12% vs. 9.00%; p < 0.001). There were 240 patients with reduced ejection fraction. Women less frequently received treatment with angiotensin converting enzyme inhibitors (26.20% vs. 36.79%), neprilysin inhibitors (6.00% vs. 13.51%), mineralocorticoid receptor antagonists (17.40% vs. 23.08%), beta-blockers (52.40% vs. 61.44%), and ivabradine (3.60% vs. 7.10%) (p < 0.001 for all), and 58% received guideline-directed medical therapy. CONCLUSIONS A selected cohort with HF and T2DM attending cardiology and endocrinology clinics did not receive optimal treatment, and this finding was more pronounced in women.
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Affiliation(s)
| | - Antonio Pérez
- Endocrinology and Nutrition Service, Hospital of Santa Creu i Sant Pau, Autonomous University of Barcelona, CIBER of Diabetes and Metabolic Diseases (CIBERDEM), Barcelona, Spain
| | - Manuel Anguita Sánchez
- Cardiology Service, Reina Sofia University Hospital, Maimonides Institute for Biomedical Research (IMIBIC), University of Cordoba, Córdoba, Spain
| | - Vivencio Barrios
- Cardiology Service, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | | | - Javier Muñiz
- University of A Coruña, Department of Health Sciences and Biomedical Research Institute, A Coruña (INIBIC), CIBERCV, Spain
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Marín F, Fernández MS, Barón-Esquivias G, Barrios V, Lekuona I, Pérez-Cabeza AI, Masjuan J, del Vigo ER, Vázquez Rodríguez JM, Freixa-Pamias R, Schilling VR, Arribas F, Priu CR, Sánchez MA. Non-embolic outcomes in patients with cardiovascular disease and atrial fibrillation treated with rivaroxaban. J Comp Eff Res 2023; 12:e220049. [PMID: 36749006 PMCID: PMC10288946 DOI: 10.57264/cer-2022-0049] [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: 03/09/2022] [Accepted: 11/25/2022] [Indexed: 02/08/2023] Open
Abstract
Aim: It is not well known how comorbidities may change the prognosis of atrial fibrillation (AF) patients. This study was aimed to analyze the impact of cardiovascular disease on this population. Materials & methods: EMIR was a multicenter, prospective study, including 1433 AF patients taking rivaroxaban for ≥6 months. Data were analyzed according to the presence of vascular disease. Results: Coronary artery disease was detected in 16.4%, peripheral artery disease/aortic plaque in 6.7%, vascular disease in 28.3%. Patients with coronary artery disease had higher rates (per 100 patient-years) of major adverse cardiovascular events (2.98 vs 0.71; p < 0.001) and cardiovascular death (1.79 vs 0.41; p = 0.004). Those with vascular disease had higher rates of thromboembolic events (1.47 vs 0.44; p = 0.007), major adverse cardiovascular events (2.03 vs 0.70; p = 0.004), and cardiovascular death (1.24 vs 0.39; p = 0.025). Patients with peripheral artery disease/aortic plaque had similar rates. Conclusion: AF patients with vascular disease have a higher risk of non-embolic outcomes.
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Affiliation(s)
- Francisco Marín
- Department of Cardiology, Hospital Clínico Universitario Virgen de la Arrixaca, IMIB-Arrixaca, University of Murcia, CIBERCV, Murcia, Spain
| | | | - Gonzalo Barón-Esquivias
- Department of Cardiology, Hospital Universitario Virgen del Rocio, Universidad de Sevilla, Sevilla, Spain
- Unidad Cardiovascular, Instituto de Biotecnología de Sevilla. Centro de Investigación en Red Cardiovascular, Madrid, Spain
| | - Vivencio Barrios
- Department of Cardiology, University Hospital Ramón y Cajal, Alcalá University, Madrid, Spain
| | | | | | - Jaime Masjuan
- Servicio de Neurología, Hospital Universitario Ramón y Cajal, IRYCIS, Departamento de Medicina, Universidad de Alcalá. Red INVICTUS, Madrid, Spain
| | | | | | | | - Vanessa Roldán Schilling
- Department of Haematology & Clinical Oncology, Hospital Universitario Morales Meseguer. University of Murcia, Murcia, Spain
| | - Fernando Arribas
- Department of Cardiology, Hospital Universitario 12 de Octubre, Department of Medicine, Facultad de Medicina, Universidad Complutense de Madrid (UCM), Madrid, Spain
- Instituto de Investigacion Sanitaria Hospital 12 de Octubre (imas12), CIBERCV, Madrid, Spain
| | | | - Manuel Anguita Sánchez
- Department of Cardiology, Hospital Reina Sofía Córdoba, IMIBIC, University of Cordoba, Córdoba, Spain
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Sánchez MA, Fiscal Ladino JA. Antimicrobial evaluation of silver nanoparticles using extracts of Crescentia cujete L. BRAZ J BIOL 2023; 84:e270215. [PMID: 37132676 DOI: 10.1590/1519-6984.270215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 03/26/2023] [Indexed: 05/04/2023] Open
Abstract
New natural reducing agents with a lower negative impact on the environment and with a high antimicrobial potential are required for the process of obtaining silver nanoparticles through the chemical reduction method. The use of plant extracts can be a fast track in the formation of nanoparticles. In this case, organic compounds such as terpenes, flavonoids, enzymes, proteins, and cofactors present in plants act as reducing agents for nanomaterials. This research evaluated the antimicrobial property of silver nanoparticles from extracts of Crescentia cujete L. The presence of quercetin (flavonoid) was determined by high-performance liquid chromatography (HPLC); the production of silver nanoparticles (AgNPs) was established by green synthesis; the size and morphology of the nanomaterials were evaluated by scanning electron microscope (SEM). The antimicrobial capacity was studied by two analysis methods: modified culture medium and surface seeding. The presence of quercetin (26.55 mg L-1) in the crude extract of Crescentia cujete L., identified by HPLC, was evidenced. Nanoparticle formation was spherical, with an average size of 250 ± 3 and 460 ± 6 nm. Microbiological cultures with treatment showed 94% microbial inhibition. It was concluded that the Crescentia cujete L., leaves shoed an acceptable concentration of quercetin to be used as a useful adjuvant to enhance the reduction of NPs synthesis. The nanoparticles produced by green synthesis proved to have a positive effect to combat pathogenic microorganisms.
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Affiliation(s)
- M A Sánchez
- Servicio Nacional de Aprendizaje - SENA, Grupo de Investigación en Ciencias Agronómicas y Pecuarias - GICAP, Cúcuta, Colombia
- Servicio Nacional de Aprendizaje - SENA, Grupo de Investigación CEDRUM NDS, Cúcuta, Colombia
| | - J A Fiscal Ladino
- Universidad de Caldas, Grupo de Investigación en Cromatografía y Técnicas Afines, Manizales, Colombia
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López-Baizán J, Ruiz Ortiz M, Delgado Ortega M, Rodríguez Almodóvar A, Esteban Martínez F, Sánchez Fernández C, Sánchez Fernández JJ, Mateos de la Haba L, Barreiro Mesa L, Ogayar Luque C, Romo Peñas E, López-Aguilera J, Carrasco Ávalos F, Castillo Domínguez JC, Anguita Sánchez M, Pan M, Mesa Rubio D. Risk scores for predicting incident heart failure admission in patients with chronic coronary syndromes: Validation in a prospective, monocentric, long-term, cohort study. Eur J Clin Invest 2022; 53:e13941. [PMID: 36573310 DOI: 10.1111/eci.13941] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 12/05/2022] [Accepted: 12/17/2022] [Indexed: 12/28/2022]
Abstract
BACKGROUND Heart failure (HF) admission in chronic coronary syndrome (CCS) patients has a prognostic impact. Stratification schemes have been described for predicting this endpoint, but none of them has been externally validated. OBJECTIVES Our aim was to develop point scores for predicting incident HF admission with data from previous studies, to perform an external validation in an independent prospective cohort and to compare their discriminative ability for this event. METHODS Independent predictive variables of HF admission in CCS patients without baseline HF were selected from four previous prospective studies (CARE, PEACE, CORONOR and CLARIFY), generating scores based on the relative magnitude of the coefficients of Cox of each variable. Finally, the scores were validated and compared in a monocentric prospective cohort. RESULTS The validation cohort included 1212 patients followed for up to 17 years, with 171 patients suffering at least one HF admission in the follow-up. Discriminative ability for predicting HF admission was statistically significant for all, and paired comparisons among them were all nonsignificant except for CORONOR score was superior to CLARIFY score (C-statistic 0.73, 95%CI 0.69-0.76 vs. 0.69, 95% CI 0.65-0.73; p = 0.03). CONCLUSION All tested scores showed significant discriminative ability for predicting incident HF admission in this independent validation study. Their discriminative ability was similar, with significant differences only between the two scores with higher and lower performance.
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Affiliation(s)
| | - Martín Ruiz Ortiz
- Cardiology Department, Reina Sofia University Hospital, Cordoba, Spain.,Maimonides Institute for Biomedical Research of Cordoba, IMIBIC, Cordoba, Spain
| | - Mónica Delgado Ortega
- Cardiology Department, Reina Sofia University Hospital, Cordoba, Spain.,Maimonides Institute for Biomedical Research of Cordoba, IMIBIC, Cordoba, Spain
| | | | | | | | | | | | | | | | - Elías Romo Peñas
- Cardiology Department, Reina Sofia University Hospital, Cordoba, Spain
| | - José López-Aguilera
- Cardiology Department, Reina Sofia University Hospital, Cordoba, Spain.,Maimonides Institute for Biomedical Research of Cordoba, IMIBIC, Cordoba, Spain
| | | | - Juan Carlos Castillo Domínguez
- Cardiology Department, Reina Sofia University Hospital, Cordoba, Spain.,Maimonides Institute for Biomedical Research of Cordoba, IMIBIC, Cordoba, Spain
| | - Manuel Anguita Sánchez
- Cardiology Department, Reina Sofia University Hospital, Cordoba, Spain.,Maimonides Institute for Biomedical Research of Cordoba, IMIBIC, Cordoba, Spain
| | - Manuel Pan
- Cardiology Department, Reina Sofia University Hospital, Cordoba, Spain.,Maimonides Institute for Biomedical Research of Cordoba, IMIBIC, Cordoba, Spain
| | - Dolores Mesa Rubio
- Cardiology Department, Reina Sofia University Hospital, Cordoba, Spain.,Maimonides Institute for Biomedical Research of Cordoba, IMIBIC, Cordoba, Spain
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Esteve-Pastor MA, Rivera-Caravaca JM, Roldán V, Sanmartin Fernández M, Arribas F, Masjuan J, Barrios V, Cosin-Sales J, Freixa-Pamias R, Recalde E, Pérez-Cabeza AI, Manuel Vázquez Rodríguez J, Ràfols Priu C, Anguita Sánchez M, Lip GYH, Marin F. Predicting performance of the HAS-BLED and ORBIT bleeding risk scores in patients with atrial fibrillation treated with Rivaroxaban: Observations from the prospective EMIR Registry. Eur Heart J Cardiovasc Pharmacother 2022; 9:38-46. [PMID: 36318457 DOI: 10.1093/ehjcvp/pvac060] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 09/22/2022] [Accepted: 10/28/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Assessing bleeding risk during the decision-making process of starting oral anticoagulation (OAC) therapy in atrial fibrillation (AF) patients is essential. Several bleeding risk scores have been proposed for vitamin K antagonist users but, few studies have focused on validation of these bleeding risk scores in patients taking direct oral anticoagulants (DOACs). The aim was to compare the predictive ability of HAS-BLED and ORBIT bleeding risk scores in AF patients taking rivaroxaban in the EMIR ('Estudio observacional para la identificación de los factores de riesgo asociados a eventos cardiovasculares mayores en pacientes con fibrilación auricular no valvular tratados con un anticoagulante oral directo [Rivaroxaban]) Study. METHODS AND RESULTS EMIR Study was an observational, multicenter, post-authorization, and prospective study that involved AF patients under OAC with rivaroxaban at least 6 months before enrolment. We analysed baseline clinical characteristics and adverse events after 2.5 years of follow-up and validated the predictive ability of HAS-BLED and ORBIT scores for major bleeding (MB) events.We analysed 1433 patients with mean age of 74.2 ± 9.7 (44.5% female). Mean HAS-BLED score was 1.6 ± 1.0 and ORBIT score was 1.1 ± 1.2. The ORBIT score categorised a higher proportion of patients as 'low-risk' (87.1%) compared with 53.5% using the HAS-BLED score. There were 33 MB events (1.04%/year) and 87 patients died (2.73%/year). Both HAS-BLED and ORBIT had a good predictive ability for MB{Area under the curve (AUC) 0.770, [95% confidence interval (CI) 0.693-0.847; P <0.001] and AUC 0.765 (95% CI 0.672-0.858; P <0.001), respectively}. There was a non-significant difference for discriminative ability of the two tested scores (P = 0.930) and risk reclassification in terms of net reclassification improvement (NRI) -5.7 (95% CI -42.4-31.1; P = 0.762). HAS-BLED score showed the best calibration and ORBIT score showed the largest mismatch in calibration, particularly in higher predicted risk patients. CONCLUSION In a prospective real-world AF population under rivaroxaban from EMIR registry, the HAS-BLED score had good predictive performance and calibration compared with ORBIT score for MB events. ORBIT score presented worse calibration than HAS-BLED in this DOAC treated population.
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Affiliation(s)
- María A Esteve-Pastor
- Department of Cardiology, Hospital Clínico Universitario Virgen de la Arrixaca, IMIB-Arrixaca, University of Murcia, Instituto Murciano de Investigación Biosanitaria (IMIB-Arrixaca), CIBERCV, 30120 Murcia, Spain
| | - José M Rivera-Caravaca
- Department of Cardiology, Hospital Clínico Universitario Virgen de la Arrixaca, IMIB-Arrixaca, University of Murcia, Instituto Murciano de Investigación Biosanitaria (IMIB-Arrixaca), CIBERCV, 30120 Murcia, Spain
| | - Vanessa Roldán
- Department of Hematology and Clinical Oncology, Hospital General Universitario Morales Meseguer, University of Murcia, IMIB-Arrixaca, 30008 Murcia, Spain
| | | | - Fernando Arribas
- Department of Cardiology, Hospital Universitario 12 de Octubre; Department of Medicine, Facultad de Medicina, Universidad Complutense de Madrid (UCM); Instituto de Investigacion Sanitaria Hospital 12 de Octubre (IMAS 12); CIBERCV, 28041 Madrid, Spain
| | - Jaime Masjuan
- Department of Neurology, University Hospital Ramón y Cajal, Madrid. Alcalá University, 28034 Madrid, Spain
| | - Vivencio Barrios
- Department of Cardiology, University Hospital Ramón y Cajal, Madrid. Alcalá University, 28034 Madrid, Spain
| | - Juan Cosin-Sales
- Department of Cardiology, Hospital Arnau de Vilanova, 46015 Valencia, Spain
| | | | - Esther Recalde
- Department of Cardiology, Hospital Universitario de Basurto, 48013 Bilbao, Spain
| | - Alejandro I Pérez-Cabeza
- Department of Cardiology, Hospital Universitario Virgen de la Victoria, CIBERCV, 29010 Málaga, Spain
| | | | | | - Manuel Anguita Sánchez
- Department of Cardiology, Hospital Reina Sofía Córdoba, IMIBIC, University of Cordoba, 14004 Córdoba, Spain
| | - Gregory Y H Lip
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, L69 7TX Liverpool, UK.,Department of Clinical Medicine, Aalborg University, 9000 Aalborg, Denmark
| | - Francisco Marin
- Department of Cardiology, Hospital Clínico Universitario Virgen de la Arrixaca, IMIB-Arrixaca, University of Murcia, Instituto Murciano de Investigación Biosanitaria (IMIB-Arrixaca), CIBERCV, 30120 Murcia, Spain
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8
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Sánchez MA, Marín F, Masjuan J, Cosín-Sales J, Rodríguez JMV, Barrios V, Barón-Esquivias G, Lekuona I, Pérez-Cabeza AI, Freixa-Pamias R, Jimenez FJP, Khatib MMK, Priu CR, Fernández MS. Impact of heart failure on the clinical profile and outcomes in patients with atrial fibrillation treated with rivaroxaban. Data from the EMIR study. Cardiol J 2022; 29:936-947. [PMID: 36200548 PMCID: PMC9788750 DOI: 10.5603/cj.a2022.0091] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 08/01/2022] [Accepted: 09/04/2022] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND The aim of this study was to analyze the impact of the presence of heart failure (HF) on the clinical profile and outcomes in patients with atrial fibrillation (AF) anticoagulated with rivaroxaban. METHODS Observational and non-interventional study that included AF adults recruited from 79 Spanish centers, anticoagulated with rivaroxaban ≥ 6 months before inclusion. Data were analyzed according to baseline HF status. RESULTS Out of 1,433 patients, 326 (22.7%) had HF at baseline. Compared to patients without HF, HF patients were older (75.3 ± 9.9 vs. 73.8 ± 9.6 years; p = 0.01), had more diabetes (36.5% vs. 24.3%; p < 0.01), coronary artery disease (28.2% vs. 12.9%; p < 0.01), renal insufficiency (31.7% vs. 22.6%; p = 0.01), higher CHA2DS2-VASc (4.5 ± 1.6 vs. 3.2 ± 1.4; p < 0.01) and HAS-BLED (1.8 ± 1.1 vs. 1.5 ± 1.0; p < 0.01). After a median follow-up of 2.5 years, among HF patients, annual rates of stroke/systemic embolism/transient ischemic attack, major adverse cardiovascular events (MACE) (non-fatal myocardial infarction, revascularization and cardiovascular death), cardiovascular death, and major bleeding were 1.2%, 3.0%, 2.0%, and 1.4%, respectively. Compared to those patients without HF, HF patients had greater annual rates of MACE (3.0% vs. 0.5%; p < 0.01) and cardiovascular death (2.0% vs. 0.2%; p < 0.01), without significant differences regarding other outcomes, including thromboembolic or bleeding events. Previous HF was an independent predictor of MACE (odds ratio 3.4; 95% confidence interval 1.6-7.3; p = 0.002) but not for thromboembolic events or major bleeding. CONCLUSIONS Among AF patients anticoagulated with rivaroxaban, HF patients had a worse clinical profile and a higher MACE risk and cardiovascular mortality. HF was independently associated with the development of MACE, but not with thromboembolic events or major bleeding.
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Affiliation(s)
- Manuel Anguita Sánchez
- Department of Cardiology, Hospital Reina Sofía Córdoba, IMIBIC, University of Cordoba, Spain
| | - Francisco Marín
- Department of Cardiology, Hospital Clínico Universitario Virgen de la Arrixaca, IMIB-Arrixaca, University of Murcia, CIBERCV, Murcia, Spain
| | - Jaime Masjuan
- Servicio de Neurología, Hospital Universitario Ramón y Cajal, IRYCIS, Departamento de Medicina, Universidad de Alcalá. Red INVICTUS, Madrid, Spain
| | - Juan Cosín-Sales
- Department of Cardiology, Hospital Arnau de Vilanova, Valencia, Spain
| | | | - Vivencio Barrios
- Department of Cardiology, University Hospital Ramón y Cajal, Madrid, Alcalá University, Madrid, Spain
| | - Gonzalo Barón-Esquivias
- Department of Cardiology, Hospital Universitario Virgen del Rocio, Universidad de Sevilla, Sevilla, Spain,Unidad Cardiovascular, Instituto de Biotecnología de Sevilla, Centro de Investigación en Red Cardiovascular, Madrid, Spain
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Heredia Campos G, Resúa Collazo A, Fernández-Avilés Irache C, Anguita Gámez P, Castillo Domínguez JC, Anguita Sánchez M. Healthcare-associated nosocomial and nosohusial infective endocarditis: are there any differences? Rev Esp Cardiol (Engl Ed) 2022; 75:960-962. [PMID: 35662677 DOI: 10.1016/j.rec.2022.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Affiliation(s)
| | | | | | - Paula Anguita Gámez
- Servicio de Odontología, Hospital HM Puerta del Sur, Móstoles, Madrid, Spain; Facultad de Odontología, Universidad San Pablo-CEU, Madrid, Spain
| | - Juan C Castillo Domínguez
- Servicio de Cardiología, Hospital Universitario Reina Sofía, Córdoba, Spain; Instituto Maimónides de Investigación Biomédica, Universidad de Córdoba, Córdoba, Spain
| | - Manuel Anguita Sánchez
- Servicio de Cardiología, Hospital Universitario Reina Sofía, Córdoba, Spain; Instituto Maimónides de Investigación Biomédica, Universidad de Córdoba, Córdoba, Spain
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10
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Marin F, Fernández MS, Lekuona I, Arribas F, Barón-Esquivias G, Barrios V, Cosin-Sales J, Freixa-Pamias R, Masjuan J, Pérez-Cabeza AI, Schilling VR, Vázquez Rodríguez JM, Priu CR, Sánchez MA. Rivaroxaban for the prevention of outcomes in patients with atrial fibrillation in clinical practice: an indirect comparison of national and international registries. J Comp Eff Res 2022; 11:1173-1184. [PMID: 36148923 DOI: 10.2217/cer-2022-0111] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Objective: To analyze the effectiveness and safety of rivaroxaban in patients with atrial fibrillation (AF). Methods: The clinical profile and outcomes of the EMIR study were indirectly compared with those of ROCKET-AF, eight other Spanish observational studies and XANTUS. Results: In EMIR, mean age was 74.2 years and CHA2DS2-VASc was 3.5. In the rivaroxaban arm of the ROCKET-AF trial, mean age was 73 years and CHADS2 was 3.5, whereas in the Spanish studies mean age ranged from 74.9 years to 78.4 years and CHA2DS2-VASc from 3.5 to 4.3. In EMIR, rates of stroke/systemic embolism, major adverse cardiovascular events, cardiovascular death and major bleeding were 0.57, 1.07, 0.63 and 1.04 events/100 patient-years, respectively. In ROCKET-AF, these numbers were 1.7, 3.91, 1.53 and 3.6 events/100 patient-years, respectively. In the Spanish studies, rates of stroke and major bleeding were 0-1.8 and 0.22-4.2 events/100 patient-years, respectively. In XANTUS, rates of stroke, major adverse cardiovascular events and major bleeding were 0.7, 1.8 and 2.1 events/100 patient-years, respectively. Conclusion: Despite the fact that rivaroxaban is prescribed for elderly patients with a high thromboembolic risk, rates of outcomes remain low.
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Affiliation(s)
- Francisco Marin
- Department of Cardiology, Hospital Clínico Universitario Virgen de la Arrixaca, IMIB-Arrixaca, University of Murcia, CIBERCV, Murcia, Spain
| | | | - Iñaki Lekuona
- Department of Cardiology, Hospital Galdakao-Usansolo, Bizkaia, Spain
| | - Fernando Arribas
- Department of Cardiology, Hospital Universitario 12 de Octubre; Department of Medicine, Facultad de Medicina, Universidad Complutense de Madrid (UCM); Instituto de Investigacion Sanitaria Hospital 12 de Octubre (imas12); CIBERCV, Madrid, Spain
| | - Gonzalo Barón-Esquivias
- Department of Cardiology, Hospital Universitario Virgen del Rocio, Universidad de Sevilla, Sevilla, Spain; Unidad Cardiovascular, Instituto de Biotecnología de Sevilla; Centro de Investigación en Red Cardiovascular, Madrid, Spain
| | - Vivencio Barrios
- Department of Cardiology, University Hospital Ramón y Cajal, Madrid; Alcalá University, Madrid, Spain
| | - Juan Cosin-Sales
- Department of Cardiology, Hospital Arnau de Vilanova, Valencia, Spain
| | - Román Freixa-Pamias
- Department of Cardiology, Hospital Universitari Complex Moisès Broggi, Barcelona, Spain
| | - Jaime Masjuan
- Department of Neurology, Hospital Universitario Ramón y Cajal, IRYCIS, Departamento de Medicina, Universidad de Alcalá. Red INVICTUS, Madrid, Spain
| | | | - Vanessa Roldán Schilling
- Department of Haematology & Clinical Oncology, Hospital Universitario Morales Meseguer, University of Murcia, Murcia, Spain
| | | | | | - Manuel Anguita Sánchez
- Department of Cardiology, Hospital Reina Sofía Córdoba, IMIBIC, University of Cordoba, Córdoba, Spain
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Anguita Gámez M, Esteban Fernández A, García Márquez M, del Prado N, Elola Somoza FJ, Anguita Sánchez M. Edad y estabilización de los ingresos por insuficiencia cardiaca en España (2006-2019). ¿El principio del fin de la «epidemia»? Rev Esp Cardiol 2022. [DOI: 10.1016/j.recesp.2022.08.015] [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: 10/14/2022]
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López-Gálvez R, Rivera-Caravaca JM, Anguita Sánchez M, Sanmartín Fernández M, Rafols C, Pérez-Cabeza AI, Barón Esquivias G, Lekuona Goya I, Vázquez Rodríguez JM, Cosín Sales J, Arribas Ynsaurriaga F, Barrios V, Freixa-Pamias R, Marín F. Use of rivaroxaban attenuates renal function impairment in patients with atrial fibrillation: insights of the EMIR study. Eur J Clin Invest 2022; 52:e13788. [PMID: 35395094 DOI: 10.1111/eci.13788] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [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: 02/04/2022] [Revised: 03/22/2022] [Accepted: 04/06/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND In atrial fibrillation (AF) patients on vitamin K antagonists, a progressive deterioration of renal function is common but there is limited evidence with long-term use of rivaroxaban. Herein, we investigated the change in renal function in AF patients after 2 years of rivaroxaban treatment. METHODS The EMIR registry is an observational and multicentre study including AF patients treated with rivaroxaban for at least 6 months prior to inclusion. Changes in analytical parameters were recorded during 2 years of follow-up. Renal function was estimated using the Cockroft-Gault equation. RESULTS 1433 patients (638, 44.5% women, mean age of 74.2 ± 9.7 years) were included. Creatinine clearance (CrCl) was available at baseline and at 2 years in 1085 patients. At inclusion, 33.2% of patients had impaired renal function (CrCl <60 ml/min). At 2 years, we were not able to find changes in the proportion of patients with impaired renal function, which increased to 34.6% (p = 0.290). However, the baseline mean CrCl was 76.0 ± 30.5 ml/min and slightly improved at 2 years (77.0 ± 31.8 ml/min; p = 0.014). Overall, the proportion of patients with CrCl <60 ml/min at baseline that had CrCl ≥60 ml/min at 2 years was significantly higher compared to that of patients with CrCl ≥60 ml/min at baseline and CrCl <60 ml/min after (22.2% vs. 13.1%; p < 0.001) CONCLUSIONS: In AF patients on long-term rivaroxaban therapy, a decrease in renal function was not observed. We even observed a slight improvement in the patients with renal impairment. These results reinforce the idea that rivaroxaban may be a safe option even in patients with renal impairment.
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Affiliation(s)
- Raquel López-Gálvez
- Department of Cardiology, Hospital Clínico Universitario Virgen de la Arrixaca, University of Murcia, Instituto Murciano de Investigación Biosanitaria (IMIB-Arrixaca), CIBERCV, Murcia, Spain
| | - José Miguel Rivera-Caravaca
- Department of Cardiology, Hospital Clínico Universitario Virgen de la Arrixaca, University of Murcia, Instituto Murciano de Investigación Biosanitaria (IMIB-Arrixaca), CIBERCV, Murcia, Spain.,Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart and Chest Hospital, UK
| | - Manuel Anguita Sánchez
- Department of Cardiology, Hospital Universitario Reina Sofía, Universidad de Córdoba, Instituto Maimónides de Investigación Biomédica (IMIBIC), Córdoba, Spain
| | | | - Carles Rafols
- Departament Medical Affairs, Bayer Hispania SL, Barcelona, Spain
| | | | - Gonzalo Barón Esquivias
- Cardiology and Cardiac Surgery Department, Hospital Universitario Virgen del Rocío, Universidad de Sevilla Institution, Seville, Spain
| | | | | | - Juan Cosín Sales
- Department of Cardiology, Hospital Arnau de Vilanova, Valencia, Spain
| | | | - Vivencio Barrios
- Department of Cardiology, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Román Freixa-Pamias
- Department of Cardiology, Complex Hospitalari Moisès Broggi, Barcelona, Spain
| | - Francisco Marín
- Department of Cardiology, Hospital Clínico Universitario Virgen de la Arrixaca, University of Murcia, Instituto Murciano de Investigación Biosanitaria (IMIB-Arrixaca), CIBERCV, Murcia, Spain
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Sanmartín Fernández M, Anguita Sánchez M, Arribas F, Barón-Esquivias G, Barrios V, Cosin-Sales J, Esteve-Pastor MA, Freixa-Pamias R, Lekuona I, Pérez-Cabeza AI, Ureña I, Vázquez Rodríguez JM, Rafols Priu C, Marin F. Outcomes and predictive value of the 2MACE score in patients with atrial fibrillation treated with rivaroxaban in a prospective, multicenter observational study: The EMIR study. Cardiol J 2022; 29:601-609. [PMID: 35621092 PMCID: PMC9273239 DOI: 10.5603/cj.a2022.0044] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 03/25/2022] [Accepted: 05/04/2022] [Indexed: 11/25/2022] Open
Abstract
Background The aim of the study was to evaluate the performance of the 2MACE in patients with atrial fibrillation (AF) treated with rivaroxaban and to improve the accuracy of 2MACE. Methods This was a post-authorization and observational study of AF adults treated with rivaroxaban for ≥ 6 months. The primary endpoint was any of the major adverse cardiac events (MACE), namely, cardiovascular death, non-fatal myocardial infarction, and myocardial revascularization. The area under the curve (AUC) was calculated to evaluate the performance of 2MACE, and a new score, 2MACER to predict MACE. Results A total of 1433 patients were included (74.2 ± 9.7 years, CHA2DS2-VASc 3.5 ± 1.5, 26.9% 2MACE ≥ 3). The annual event rates (follow-up 2.5 years) were 1.07% for MACE, 0.66% for thromboembolic events and 1.04% for major bleeding. Patients with 2MACE ≥ 3 (vs. < 3) had higher risk of stroke/systemic embolism/transient ischemic attack (odds ratio [OR] 5.270; 95% confidence interval [CI] 2.216–12.532), major bleeding (OR 4.624; 95% CI 2.163–9.882), MACE (OR 3.202; 95% CI 1.548–6.626) and cardiovascular death (OR 3.395; 95% CI 1.396–8.259). 2MACE was recalculated giving 1 more point to patients with baseline a glomerular filtration rate < 50 mL/min/1.73 m2 (2MACER); (2MACER vs. 2MACE: IDI 0.1%, p = 0.126; NRI 23.9%, p = 0.125; AUC: 0.651 [95% CI 0.547–0.755] vs. 0.638 [95% CI 0.534–0.742], respectively; p = 0.361). Conclusions In clinical practice, AF patients anticoagulated with rivaroxaban exhibit a low risk of events. 2MACE score acts as a modest predictor of a higher risk of adverse outcomes in this population. 2MACER did not significantly increase the ability of 2MACE to predict MACE.
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Affiliation(s)
| | - Manuel Anguita Sánchez
- Department of Cardiology, Hospital Reina Sofía Córdoba, IMIBIC, University of Cordoba, Córdoba, Spain
| | - Fernando Arribas
- Department of Cardiology, Hospital Universitario 12 de Octubre; Department of Medicine, Facultad de Medicina, Universidad Complutense de Madrid (UCM); Instituto de Investigacion Sanitaria Hospital 12 de Octubre (imas12); CIBERCV, Madrid, Spain
| | - Gonzalo Barón-Esquivias
- Department of Cardiology, Hospital Universitario Virgen del Rocio, Universidad de Sevilla, Sevilla, Spain. Unidad Cardiovascular, Instituto de Biotecnología de Sevilla. Centro de Investigación en Red Cardiovascular, Madrid, Spain
| | - Vivencio Barrios
- Department of Cardiology, University Hospital Ramón y Cajal, Madrid. Alcalá University, Madrid, Spain
| | - Juan Cosin-Sales
- Department of Cardiology, Hospital Arnau de Vilanova, Valencia, Spain
| | - María Asunción Esteve-Pastor
- Department of Cardiology, Hospital Clínico Universitario Virgen de la Arrixaca, IMIB-Arrixaca, University of Murcia, CIBERCV, Murcia, Spain
| | | | | | | | - Isabel Ureña
- Department of Cardiology, Hospital Universitario Morales Meseguer, Murcia, Spain
| | | | | | - Francisco Marin
- Department of Cardiology, Hospital Clínico Universitario Virgen de la Arrixaca, IMIB-Arrixaca, University of Murcia, CIBERCV, Murcia, Spain
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Heredia Campos GM, Perea Armijo J, Anguita Sánchez M. Apixaban and intraventricular thrombus resolution in a patient with an AMI. Rev Esp Cardiol (Engl Ed) 2022; 75:442-443. [PMID: 35148967 DOI: 10.1016/j.rec.2021.11.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Accepted: 11/16/2021] [Indexed: 06/14/2023]
Affiliation(s)
| | - Jorge Perea Armijo
- Servicio de Cardiología, Hospital Universitario Reina Sofía, Córdoba, Spain
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15
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Heredia Campos G, Resúa Collazo A, Fernández-Avilés Irache C, Anguita Gámez P, Castillo Domínguez JC, Anguita Sánchez M. Endocarditis infecciosa nosocomial y nosohusial en relación con la atención sanitaria: ¿existen diferencias? Rev Esp Cardiol 2022. [DOI: 10.1016/j.recesp.2022.04.002] [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: 11/26/2022]
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16
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Anguita Sánchez M, Bonilla Palomas JL, García Márquez M, Bernal Sobrino JL, Elola Somoza FJ, Marín Ortuño F. Tendencias temporales de las tasas de frecuentación y mortalidad hospitalaria de la insuficiencia cardiaca en España por edad y sexo (2003-2018). Rev Esp Cardiol 2021. [DOI: 10.1016/j.recesp.2021.04.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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17
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Anguita Sánchez M, Bonilla Palomas JL, García Márquez M, Bernal Sobrino JL, Elola Somoza FJ, Marín Ortuño F. Temporal trends in hospitalization and in-hospital mortality rates due to heart failure by age and sex in Spain (2003-2018). Rev Esp Cardiol (Engl Ed) 2021; 74:993-996. [PMID: 34176775 DOI: 10.1016/j.rec.2021.04.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 04/29/2021] [Indexed: 10/21/2022]
Affiliation(s)
- Manuel Anguita Sánchez
- Servicio de Cardiología, Hospital Universitario Reina Sofía, Córdoba, Spain; Instituto Maimónides de Investigación Biomédica, Universidad de Córdoba, Córdoba, Spain.
| | | | - María García Márquez
- Servicio de Control de Gestión, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - José Luis Bernal Sobrino
- Servicio de Control de Gestión, Hospital Universitario 12 de Octubre, Madrid, Spain; Fundación Instituto para la Mejora de la Asistencia Sanitaria, Madrid, Spain
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Fernández MS, Marín F, Rafols C, Arribas F, Barrios V, Cosín-Sales J, Sánchez MA. Thromboembolic and bleeding events with rivaroxaban in clinical practice in Spain: impact of inappropriate doses (the EMIR study). J Comp Eff Res 2021; 10:583-593. [PMID: 33787316 DOI: 10.2217/cer-2020-0286] [Citation(s) in RCA: 6] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Aim: To analyze the frequency and variables related to inappropriate rivaroxaban dosage in clinical practice and its impact on outcomes after 2 years. Materials & methods: Postauthorization, observational, multicenter study, in which atrial fibrillation patients, treated with rivaroxaban ≥6 months were included. Results: A total of 1421 patients (74.2 ± 9.7 years, CHA2DS2-VASc 3.5 ± 1.6) were included. Overall, 22.9% received rivaroxaban 15 mg. The proper dose of rivaroxaban was taken by 83.3% (9.7% underdosed, 7.0% overdosed). Older age and renal insufficiency were associated with inadequate rivaroxaban dosage. There was a trend toward higher all-cause mortality among underdosed patients (adjusted hazard ratio 1.39; 95% CI 0.75-2.58), and more bleedings in overdosed patients (2.29 vs 0.80 events/100 patient-years; p = 0.14). Conclusion: In clinical practice, rivaroxaban is properly dosed in most patients.
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Affiliation(s)
| | - Francisco Marín
- Department of Cardiology, Hospital Clínico Universitario Virgen de la Arrixaca, IMIB-Arrixaca, University of Murcia, CIBERCV, Murcia, Spain
| | - Carles Rafols
- Department of Medical Affairs, Bayer Hispania, Barcelona, Spain
| | - Fernando Arribas
- Department of Cardiology, Hospital Universitario 12 de Octubre; Department of Medicine, Facultad de Medicina, Universidad Complutense de Madrid (UCM); Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12); CIBERCV, Madrid, Spain
| | - Vivencio Barrios
- Department of Cardiology, Hospital Ramón y Cajal; Alcalá University, Madrid, Spain
| | - Juan Cosín-Sales
- Department of Cardiology, Hospital Arnau de Vilanova, Valencia, Spain
| | - Manuel Anguita Sánchez
- Department of Cardiology, Hospital Universitario Reina Sofia, IMIBIC, University of Córdoba, Córdoba, Spain
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Martín García A, Mitroi C, Mazón Ramos P, García Sanz R, Virizuela JA, Arenas M, Egocheaga Cabello I, Albert D, Anguita Sánchez M, Arrarte Esteban VI, Ayala de la Peña F, Bonanand Lozano C, Castro A, Castro Fernández A, Córdoba R, Cosín-Sales J, Chaparro-Muñoz M, Dalmau R, Drak Hernández Y, Deiros Bronte L, Díez-Villanueva P, Escobar Cervantes C, Fernández Redondo C, García Rodríguez E, Lozano T, Marco Vera P, Martínez Monzonis A, Mesa D, Oristrell G, Palma Gámiz JL, Pedreira M, Reinoso-Barbero L, Rodríguez I, Serrano Antolín JM, Toral B, Torres Royo L, Velasco Del Castillo S, Vicente-Herrero T, Zatarain-Nicolás E, Tamargo J, López Fernández T. Stratification and management of cardiovascular risk in cancer patients. A consensus document of the SEC, FEC, SEOM, SEOR, SEHH, SEMG, AEEMT, AEEC, and AECC. ACTA ACUST UNITED AC 2021; 74:438-448. [PMID: 33712348 DOI: 10.1016/j.rec.2020.11.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 11/12/2020] [Indexed: 12/12/2022]
Abstract
Both cancer treatment and survival have significantly improved, but these advances have highlighted the deleterious effects of vascular complications associated with anticancer therapy. This consensus document aims to provide a coordinated, multidisciplinary and practical approach to the stratification, monitoring and treatment of cardiovascular risk in cancer patients. The document is promoted by the Working Group on Cardio Oncology of the Spanish Society of Cardiology (SEC) and was drafted in collaboration with experts from distinct areas of expertise of the SEC and the Spanish Society of Hematology and Hemotherapy (SEHH), the Spanish Society of Medical Oncology (SEOM), the Spanish Society of Radiation Oncology (SEOR), the Spanish Society of General and Family Physicians (SEMG), the Spanish Association of Specialists in Occupational Medicine (AEEMT), the Spanish Association of Cardiovascular Nursing (AEEC), the Spanish Heart Foundation (FEC), and the Spanish Cancer Association (AECC).
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Affiliation(s)
- Ana Martín García
- Servicio de Cardiología, Complejo Asistencial Universitario de Salamanca (CAUSA), IBSAL, USAL, Salamanca, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV-ISCIII), Spain.
| | - Cristina Mitroi
- Servicio de Cardiología, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain
| | - Pilar Mazón Ramos
- Servicio de Cardiología, Hospital Clínico Universitario de Santiago, Santiago de Compostela, A Coruña, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV-ISCIII), Spain
| | - Ramón García Sanz
- Servicio de Hematología, Complejo Asistencial Universitario de Salamanca (CAUSA), IBSAL, Salamanca, Spain; Centro de Investigación Biomédica en Red de Cáncer (CIBERONC-ISCIII), Spain
| | | | - Meritxell Arenas
- Servicio de Oncología Radioterápica, Hospital Universitario San Juan de Reus, Universidad Rovira i Virgili, Reus, Tarragona, Spain
| | | | - Dimpna Albert
- Servicio de Cardiología Pediátrica, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | | | | | | | | | - Almudena Castro
- Servicio de Cardiología, Hospital Universitario La Paz, IdiPAZ, Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV-ISCIII), Spain
| | | | - Raúl Córdoba
- Servicio de Hematología, Fundación Jiménez Díaz, Madrid, Spain
| | - Juan Cosín-Sales
- Servicio de Cardiología, Hospital Arnau de Vilanova, Valencia, Spain
| | | | - Regina Dalmau
- Servicio de Cardiología, Hospital Universitario La Paz, IdiPAZ, Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV-ISCIII), Spain
| | | | - Lucía Deiros Bronte
- Servicio de Cardiología Pediátrica, Hospital Universitario La Paz, Madrid, Spain
| | | | - Carlos Escobar Cervantes
- Servicio de Cardiología, Hospital Universitario La Paz, IdiPAZ, Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV-ISCIII), Spain
| | | | | | - Teresa Lozano
- Servicio de Cardiología, Hospital General Universitario de Alicante, ISABIAL, Alicante, Spain
| | - Pascual Marco Vera
- Servicio de Hematología y Hemoterapia, Hospital General Universitario de Alicante, ISABIAL, Alicante, Spain
| | - Amparo Martínez Monzonis
- Servicio de Cardiología, Hospital Clínico Universitario de Santiago, Santiago de Compostela, A Coruña, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV-ISCIII), Spain
| | - Dolores Mesa
- Servicio de Cardiología, Hospital Universitario Reina Sofía, Córdoba, Spain
| | - Gerard Oristrell
- Servicio de Cardiología, Hospital Universitario Vall d'Hebron, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV-ISCIII), Spain
| | | | - Milagros Pedreira
- Servicio de Cardiología, Hospital Clínico Universitario de Santiago, Santiago de Compostela, A Coruña, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV-ISCIII), Spain
| | | | - Isabel Rodríguez
- Servicio de Oncología Radioterápica, Hospital Universitario La Paz, Madrid, Spain
| | | | - Belén Toral
- Servicio de Cardiología Pediátrica, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Laura Torres Royo
- Servicio de Oncología Radioterápica, Hospital Universitario San Juan de Reus, Universidad Rovira i Virgili, Reus, Tarragona, Spain
| | | | | | - Eduardo Zatarain-Nicolás
- Servicio de Cardiología, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IISGM), Universidad Complutense, Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV-ISCIII), Spain
| | - Juan Tamargo
- Departamento de Farmacología, Facultad de Medicina, Universidad Complutense, Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV-ISCIII), Spain
| | - Teresa López Fernández
- Servicio de Cardiología, Hospital Universitario La Paz, IdiPAZ, Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV-ISCIII), Spain
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Anguita Sánchez M, Gómez Doblas JJ, Barrios Alonso V. [Continuity of care and protocols for lipid goals control after an acute coronary syndrome in Spain]. Aten Primaria 2021; 53:101980. [PMID: 33592534 PMCID: PMC7893427 DOI: 10.1016/j.aprim.2021.101980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 07/31/2020] [Indexed: 11/25/2022] Open
Affiliation(s)
- Manuel Anguita Sánchez
- Servicio de Cardiología, Hospital Universitario Reina Sofía, Córdoba, España; Servicio de Cardiología, Hospital Quirón Salud, Córdoba, España.
| | - Juan J Gómez Doblas
- Servicio de Cardiología, Hospital Clínico Virgen de la Victoria, Málaga, España
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Anguita Sánchez M, Gómez Doblas JJ, Barrios Alonso V. Grado de control del cLDL tras un síndrome coronario agudo en España. ¿Se utilizan adecuadamente los recursos terapéuticos existentes? Rev Esp Cardiol 2021. [DOI: 10.1016/j.recesp.2020.06.011] [Citation(s) in RCA: 3] [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: 12/27/2022]
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Anguita Sánchez M, Gómez Doblas JJ, Barrios Alonso V. Control of LDL-C levels after an acute coronary syndrome in Spain. Are the available treatments adequately used? Rev Esp Cardiol (Engl Ed) 2021; 74:194-196. [PMID: 32792311 DOI: 10.1016/j.rec.2020.06.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 06/03/2020] [Indexed: 06/11/2023]
Affiliation(s)
- Manuel Anguita Sánchez
- Servicio de Cardiología, Hospital Universitario Reina Sofía, Córdoba, Spain; Servicio de Cardiología, Hospital Quirón Salud, Córdoba, Spain.
| | - Juan J Gómez Doblas
- Servicio de Cardiología, Hospital Clínico Virgen de la Victoria, Málaga, Spain
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Anguita Sánchez M, Bonilla Palomas JL, García Márquez M, Bernal Sobrino JL, Fernández Pérez C, Elola Somoza FJ. Temporal trends in hospitalizations and in-hospital mortality in heart failure in Spain 2003-2015: differences between autonomous communities. Rev Esp Cardiol (Engl Ed) 2020; 73:1075-1077. [PMID: 32800487 DOI: 10.1016/j.rec.2020.05.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 05/22/2020] [Indexed: 06/11/2023]
Affiliation(s)
- Manuel Anguita Sánchez
- Servicio de Cardiología, Hospital Universitario Reina Sofía, Córdoba, Spain; Servicio de Cardiología, Hospital Quirón Salud, Córdoba, Spain.
| | | | | | - José Luis Bernal Sobrino
- Fundación Instituto para la Mejora de la Asistencia Sanitaria, Madrid, Spain; Servicio de Control de Gestión, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Cristina Fernández Pérez
- Servicio de Cardiología, Hospital San Juan de la Cruz, Úbeda, Jaén, Spain; Instituto de Investigación Sanitaria, Hospital Clínico San Carlos, Madrid, Spain; Departamento de Medicina Preventiva, Hospital Clínico San Carlos, Madrid, Spain
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Anguita Sánchez M, Bonilla Palomas JL, García Márquez M, Bernal Sobrino JL, Fernández Pérez C, Elola Somoza FJ. Tendencias temporales en ingresos y mortalidad hospitalaria por insuficiencia cardiaca en España, 2003-2015: diferencias por comunidades autónomas. Rev Esp Cardiol 2020. [DOI: 10.1016/j.recesp.2020.05.025] [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: 11/16/2022]
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Roldán Rabadán I, Esteve-Pastor MA, Anguita Sánchez M, Muñiz J, Ruiz Ortiz M, Marín F, Roldán V, Quesada MA, Camacho Siles J, Cequier Fillat A, Bertomeu Martinez V, Martínez Sellés M, Badimón L. Influence of sex on long-term prognosis in patients with atrial fibrillation treated with oral anticoagulants. Results from the prospective, nationwide FANTASIIA study. Eur J Intern Med 2020; 78:63-68. [PMID: 32303456 DOI: 10.1016/j.ejim.2020.04.012] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Revised: 03/27/2020] [Accepted: 04/03/2020] [Indexed: 12/30/2022]
Abstract
BACKGROUND While many risk factors for Atrial Fibrillation (AF) have been identified, there are important differences in their relative impact between sexes. The aim of our study was to investigate the influence of sex as a long-term predictor of adverse events in "real world" AF patients treated with direct oral anticoagulants. METHODS The FANTASIIA registry is a prospective, national and multicentric study including outpatients with anticoagulated AF patients. Baseline characteristics and adverse events at 3 years of follow-up were collected and classified by sex. Cox multivariate analysis was performed to investigate the role of sex in major events and composite outcomes. RESULTS A total of 1956 patients were included in the study. 43.9% of them were women, with a mean age of 73.8 ± 9.4 years (women were older 76.5 ± 7.9 vs 71.7 ± 10.1, p<0.001). Women had higher rate of cardiovascular risk factors and higher mean of CHA2DS2-VASc (4.4 ± 1.4 vs 3.7 ± 1.6, p<0.001) and HAS-BLED (2.1 ± 1.0 vs 1.9 ± 1.1, p<0.001) than men. After 3 years of follow-up, rates of major events were similar in both groups with limit difference for all-cause mortality (4.4%/year in women vs 5.6%/year in men; p = 0.056). However, all the composite events were more frequent in women. We observed in the non-adjusted adverse events lower rate of all-cause mortality (HR 0.62, 95%CI 0.47-0.81; p<0.001), composite 1 outcomes (HR 0.80, 95%CI 0.65-0.98; p = 0.029) and composite 2 (HR 0.77, 95%CI 0.64-0.94; p = 0.010) in women compared with men. In multivariate Cox regression analysis observed that female sex was an independently protector factor for all-cause mortality and for the composite outcomes 1 and 2. CONCLUSIONS In this "real world" study of anticoagulated AF patients, women could have a protective role against development of adverse events, mainly on all-cause mortality and combined events.
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Affiliation(s)
- Inmaculada Roldán Rabadán
- Department of Cardiology, Hospital Universitario La Paz, Po. Castellana 261, 28046 Madrid, Spain; Instituto de Investigación de La Paz (IDIPAZ), CIBER-CV, Spain.
| | - María Asunción Esteve-Pastor
- Department of Cardiology, Hospital Clínico Universitario Virgen de la Arrixaca, Instituto Murciano de Investigación Biosanitaria, IMIB-Arrixaca, CIBER-CV, Murcia, Spain
| | | | - Javier Muñiz
- Universidade da Coruña, Instituto Universitario de Ciencias de la Salud, Instituto de Investigación Biomédica de A Coruña (INIBIC), La Coruña, Spain
| | - Martín Ruiz Ortiz
- Department of Cardiology, Hospital Universitario Reina Sofía, Córdoba, Spain
| | - Francisco Marín
- Department of Cardiology, Hospital Clínico Universitario Virgen de la Arrixaca, Instituto Murciano de Investigación Biosanitaria, IMIB-Arrixaca, CIBER-CV, Murcia, Spain
| | | | | | - José Camacho Siles
- Department of Internal Medicine, Hospital Universitario La Paz, Madrid, Spain
| | | | | | - Manuel Martínez Sellés
- Department of Cardiology, Hospital Universitario Gregorio Marañón, CIBERCV, Complutense University, European University of Madrid, Madrid, Spain
| | - Lina Badimón
- Cardiovascular Research Center, CSIC-ICCC, Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau, Barcelona, Spain
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Abstract
Chile has become one of the main global players in seed production for counter-season markets and research purposes. Chile has a key role contributing to the reduction in seed production shortages in the Northern Hemisphere by speeding up the development of new hybrids, cultivars, and genetically modified (GM) organisms. The seeds that Chile produces for export include a considerable amount of GM seeds. Between 2009 and 2018, 1,081 different seed-planting events were undertaken for seed multiplication and/or research purposes. Every single event that had commodity cultivation status in 2018 in at least one country underwent field activities in Chile at least once over the last 10 y. Chile just adopted a regulatory approach for new plant breeding techniques. This type of regulatory approach should contribute to maintaining the status of Chile as a hot spot for future innovation in plant breeding-based biotechnology.
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Anguita Sánchez M, Arribas Ynsaurriaga F, Cequier Fillat Á, de Teresa Galván E, Lekuona Goya I, Zamorano Gómez JL. Differences between cardiologists' perceptions and clinical reality of the quality of anticoagulation with vitamin K antagonists in Spain. Rev Esp Cardiol (Engl Ed) 2020; 73:332-334. [PMID: 31879233 DOI: 10.1016/j.rec.2019.09.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Accepted: 09/19/2019] [Indexed: 06/10/2023]
Affiliation(s)
- Manuel Anguita Sánchez
- Servicio de Cardiología, Hospital Universitario Reina Sofía, Córdoba, Spain; Servicio de Cardiología, Hospital QuirónSalud, Córdoba, Spain.
| | | | - Ángel Cequier Fillat
- Servicio de Cardiología, Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
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Sánchez Fernández JJ, Ruiz Ortiz M, Ogayar Luque C, Cantón Gálvez JM, Romo Peñas E, Mesa Rubio D, Delgado Ortega M, Castillo Domínguez JC, Anguita Sánchez M, López Aguilera J, Carrasco Ávalos F, Pan Álvarez-Ossorio M. Long-term Survival in a Spanish Population With Stable Ischemic Heart Disease. The CICCOR Registry. Rev Esp Cardiol (Engl Ed) 2019; 72:827-834. [PMID: 30268655 DOI: 10.1016/j.rec.2018.08.019] [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: 01/04/2018] [Accepted: 06/12/2018] [Indexed: 06/08/2023]
Abstract
INTRODUCTION AND OBJECTIVES Data are lacking on the long-term prognosis of stable ischemic heart disease (SIHD). Our aim was to analyze long-term survival in patients with SIHD and to identify predictors of mortality. METHODS A total of 1268 outpatients with SIHD were recruited in this single-center prospective cohort study from January 2000 to February 2004. Cardiovascular and all-cause death during follow-up were registered. All-cause and cardiovascular mortality rates were compared with those in the Spanish population adjusted by age, sex, and year. Predictors of these events were investigated. RESULTS The mean age was 68±10 years and 73% of the patients were male. After a follow-up lasting up to 17 years (median 11 years), 629 (50%) patients died. Independent predictors of all-cause mortality were age (HR, 1.08; 95%CI, 1.07-1.11; P <.001), diabetes (HR, 1.36; 95%CI, 1.14-1.63; P <.001), resting heart rate (HR, 1.01; 95%CI, 1.00-1.02; P <.001), atrial fibrillation (HR, 1.61; 95%CI, 1.22-2.14; P=.001), electrocardiographic changes (HR, 1.23; 95%CI, 1.02-1.49; P=.02) and active smoking (HR, 1.85; 95%CI, 1.31-2.80; P=.001). All-cause mortality and cardiovascular mortality rates were significantly higher in the sample than in the general Spanish population (47.81/1000 patients/y vs 36.29/1000 patients/y (standardized mortality rate, 1.31; 95%CI, 1.21-1.41) and 15.25/1000 patients/y vs 6.94/1000 patients/y (standardized mortality rate, 2.19; 95%CI, 1.88-2.50, respectively). CONCLUSIONS The mortality rate was higher in this sample of patients with SIHD than in the general population. Several clinical variables can identify patients at higher risk of death during follow-up.
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Affiliation(s)
| | - Martín Ruiz Ortiz
- Servicio de Cardiología, Hospital Universitario Reina Sofía, Córdoba, Spain
| | | | | | - Elías Romo Peñas
- Servicio de Cardiología, Hospital Universitario Reina Sofía, Córdoba, Spain
| | - Dolores Mesa Rubio
- Servicio de Cardiología, Hospital Universitario Reina Sofía, Córdoba, Spain
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Sánchez Fernández JJ, Ruiz Ortiz M, Ogayar Luque C, Cantón Gálvez JM, Romo Peñas E, Mesa Rubio D, Delgado Ortega M, Castillo Domínguez JC, Anguita Sánchez M, López Aguilera J, Carrasco Ávalos F, Pan Álvarez-Ossorio M. Supervivencia a largo plazo de una población española con cardiopatía isquémica estable: el registro CICCOR. Rev Esp Cardiol 2019. [DOI: 10.1016/j.recesp.2018.06.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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López-Fernández T, Martín-García A, Roldán Rabadán I, Mitroi C, Mazón Ramos P, Díez-Villanueva P, Escobar Cervantes C, Alonso Martín C, Alonso Salinas GL, Arenas M, Arrarte Esteban VI, Ayala de La Peña F, Castro Fernández A, García Pardo H, García-Sanz R, González Porras JR, López de Sá E, Lozano T, Marco Vera P, Martínez Marín V, Mesa Rubio D, Montero Á, Oristrell G, Pérez de Prado A, Velasco del Castillo S, Virizuela Echaburu JA, Zatarain-Nicolás E, Anguita Sánchez M, Tamargo Menéndez J, Marín F, López-Sendón JL, Zamorano JL. Abordaje de la fibrilación auricular en pacientes con cáncer activo. Documento de consenso de expertos y recomendaciones. Rev Esp Cardiol 2019. [DOI: 10.1016/j.recesp.2019.03.017] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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López-Fernández T, Martín-García A, Roldán Rabadán I, Mitroi C, Mazón Ramos P, Díez-Villanueva P, Escobar Cervantes C, Alonso Martín C, Alonso Salinas GL, Arenas M, Arrarte Esteban VI, Ayala de La Peña F, Castro Fernández A, García Pardo H, García-Sanz R, González Porras JR, López de Sá E, Lozano T, Marco Vera P, Martínez Marín V, Mesa Rubio D, Montero Á, Oristrell G, Pérez de Prado A, Velasco Del Castillo S, Virizuela Echaburu JA, Zatarain-Nicolás E, Anguita Sánchez M, Tamargo Menéndez J. Atrial Fibrillation in Active Cancer Patients: Expert Position Paper and Recommendations. ACTA ACUST UNITED AC 2019; 72:749-759. [PMID: 31405794 DOI: 10.1016/j.rec.2019.03.019] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Accepted: 03/28/2019] [Indexed: 12/13/2022]
Abstract
Improvements in survival among cancer patients have revealed the clinical impact of cardiotoxicity on both cardiovascular and hematological and oncological outcomes, especially when it leads to the interruption of highly effective antitumor therapies. Atrial fibrillation is a common complication in patients with active cancer and its treatment poses a major challenge. These patients have an increased thromboembolic and hemorrhagic risk but standard stroke prediction scores have not been validated in this population. The aim of this expert consensus-based document is to provide a multidisciplinary and practical approach to the prevention and treatment of atrial fibrillation in patients with active cancer. This is a position paper of the Spanish Cardio-Oncology working group and the Spanish Thrombosis working group, drafted in collaboration with experts from the Spanish Society of Cardiology, the Spanish Society of Medical Oncology, the Spanish Society of Radiation Oncology, and the Spanish Society of Hematology.
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Affiliation(s)
| | - Ana Martín-García
- Servicio de Cardiología, Complejo Asistencial Universitario de Salamanca (CAUSA), IBSAL, CIBERCV, Salamanca, Spain
| | | | - Cristina Mitroi
- Servicio de Cardiología, Hospital Puerta de Hierro, Majadahonda, Madrid, Spain
| | - Pilar Mazón Ramos
- Servicio de Cardiología, Hospital Clínico Santiago de Compostela, CIBERCV, Santiago de Compostela, A Coruña, Spain
| | | | | | | | | | - Meritxell Arenas
- Servicio de Oncología Radioterápica, Hospital Universitario San Juan de Reus, Universidad Rovira i Virgili, Reus, Tarragona, Spain
| | | | | | | | - Héctor García Pardo
- Servicio de Cardiología, Hospital Santos Reyes, Aranda de Duero, Burgos, Spain
| | - Ramón García-Sanz
- Departamento de Hematología, Complejo Asistencial Universitario de Salamanca (CAUSA), IBSAL, Salamanca, Spain
| | - José Ramón González Porras
- Departamento de Hematología, Complejo Asistencial Universitario de Salamanca (CAUSA), IBSAL, Salamanca, Spain
| | - Esteban López de Sá
- Servicio de Cardiología, Hospital Universitario La Paz, IdiPAZ, CIBERCV, Madrid, Spain
| | - Teresa Lozano
- Servicio de Cardiología, Hospital General Universitario de Alicante, ISABIAL-FISABIO, Alicante, Spain
| | - Pascual Marco Vera
- Servicio de Hematología, Hospital General Universitario de Alicante, ISABIAL-FISABIO, Alicante, Spain
| | | | - Dolores Mesa Rubio
- Servicio de Cardiología, Hospital Universitario Reina Sofía, Córdoba, Spain
| | - Ángel Montero
- Servicio de Oncología Radioterápica, Centro Integral Oncológico Clara Campal (CIOCC), Hospital Universitario HM Sanchinarro, Madrid, Spain
| | - Gerard Oristrell
- Servicio de Cardiología, Hospital Universitario Vall d'Hebron, CIBERCV, Barcelona, Spain
| | | | | | | | - Eduardo Zatarain-Nicolás
- Servicio de Cardiología, Hospital General Universitario Gregorio Marañón, CIBERCV, Madrid, Spain
| | | | - Juan Tamargo Menéndez
- Departamento de Farmacología, Facultad de Medicina, Universidad Complutense, CIBERCV, Madrid, Spain
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Bañeras Rius J, Huelmos A, Anguita Sánchez M. Health Care Simulation in Cardiology: Promises and Realities. Rev Esp Cardiol (Engl Ed) 2019; 72:606-607. [PMID: 31109790 DOI: 10.1016/j.rec.2019.02.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Accepted: 02/21/2019] [Indexed: 06/09/2023]
Affiliation(s)
- Jordi Bañeras Rius
- Institut de Recerca del Hospital Vall d'Hebron, Servicio de Cardiología del Hospital Universitari Vall d'Hebron, CIBERCV, Barcelona, Spain.
| | - Ana Huelmos
- Servicio de Cardiología, Hospital Universitario Fundación Alcorcón, Madrid, Spain
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Anguita Sánchez M, Alonso Martín JJ, Cequier Fillat Á, Gómez Doblas JJ, Pulpón Rivera L, Lekuona Goya I, Rodríguez Rodrigo F, Íñiguez Romo A, Macaya Miguel C, Evangelista Masip A, Silva Melchor L, Bueno H, Díaz Molina B, Ferreira-González I, Elola Somoza FJ. El Cardiólogo y la Cardiología del Futuro: visión y propuestas de la Sociedad Española de Cardiología para la cardiología del siglo XXI. Rev Esp Cardiol 2019. [DOI: 10.1016/j.recesp.2019.02.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Anguita Sánchez M, Alonso Martín JJ, Cequier Fillat Á, Gómez Doblas JJ, Pulpón Rivera L, Lekuona Goya I, Rodríguez Rodrigo F, Íñiguez Romo A, Macaya Miguel C, Evangelista Masip A, Silva Melchor L, Bueno H, Díaz Molina B, Ferreira-González I, Elola Somoza FJ. Cardiologists and the Cardiology of the Future. Vision and proposals of the Spanish Society of Cardiology for the Cardiology of the 21st Century. Rev Esp Cardiol (Engl Ed) 2019; 72:649-657. [PMID: 31311762 DOI: 10.1016/j.rec.2019.02.025] [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: 01/12/2019] [Accepted: 02/07/2019] [Indexed: 06/10/2023]
Abstract
The Cardiology of the Future is a project of the Spanish Society of Cardiology (SEC) whose objectives are as follows: to define the action policies of the SEC; to analyze the trends and changes in the environment that will influence the practice of cardiology in Spain; to define the profile of the cardiologists needed in the future; to propose policies to achieve the objectives resulting from the identified needs; and to identify the role of the SEC in the development and implementation of these policies. This article describes the methodology and the most relevant findings of the final report of this project and the strategic lines to be developed by the SEC in the immediate future, resulting from the analysis performed.
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Affiliation(s)
- Manuel Anguita Sánchez
- Servicio de Cardiología, Complejo Hospitalario Universitario Reina Sofía, Córdoba, España
| | | | - Ángel Cequier Fillat
- Servicio de Cardiología, Hospital Universitario de Bellvitge, IDIBELL, L'Hospitalet de Llobregat, Barcelona, España
| | - Juan José Gómez Doblas
- Servicio de Cardiología, Hospital Clínico Universitario Virgen de la Victoria, Málaga, España
| | - Luis Pulpón Rivera
- Servicio de Cardiología, Hospital Universitario Puerta de Hierro-Majadahonda, Majadahonda, Madrid, España
| | - Iñaki Lekuona Goya
- Servicio de Cardiología, Hospital Galdakao Usansolo, Galdácano, Vizcaya, España
| | | | - Andrés Íñiguez Romo
- Servicio de Cardiología, Hospital Álvaro Cunqueiro, Vigo, Pontevedra, España
| | - Carlos Macaya Miguel
- Servicio de Cardiología, Hospital Clínico Universitario San Carlos, Madrid, España
| | | | - Lorenzo Silva Melchor
- Servicio de Cardiología, Hospital Universitario Puerta de Hierro-Majadahonda, Majadahonda, Madrid, España
| | - Héctor Bueno
- Servicio de Cardiología, Hospital Universitario 12 de Octubre, Madrid, España; Centro Nacional de Investigaciones Cardiovasculares (CNIC), España
| | - Beatriz Díaz Molina
- Servicio de Cardiología, Hospital Universitario Central de Asturias, Oviedo, Asturias, España
| | - Ignacio Ferreira-González
- Servicio de Cardiología, Hospital Universitario Vall d'Hebron, Barcelona, España; Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), España
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Plaza-Martín M, Sanmartin-Fernandez M, Álvarez-Álvarez B, Andrea R, Seoane-García T, González-D'Gregorio J, Hernández-Betancor I, Rozado J, Carrasco-Ávalos F, Del Mar Alameda-Ortiz M, Gómez-Talavera S, Sanchís J, Anguita Sánchez M, Peral-Disdier V, Ibáñez B, Del Prado Díaz S, Zamorano Gómez JL. Contemporary differences between men and women with acute coronary syndromes: CIAM multicenter registry. J Cardiovasc Med (Hagerstown) 2019; 20:525-530. [PMID: 31260420 DOI: 10.2459/jcm.0000000000000812] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
AIM Differences exist in the diagnosis and treatment of acute coronary syndrome (ACS) between men and women. However, recent advancements in the management of ACSs might have attenuated this sex gap. We evaluated the status of ACS management in a multicenter registry in 10 tertiary Spanish hospitals. METHODS We enrolled 1056 patients in our study, including only those with type 1 myocardial infarctions or unstable angina presumably not related to a secondary cause in an 'all-comers' design. RESULTS The women enrolled (29%) were older than men (71.0 ± 12.8 vs. 64.0 ± 12.3, P = 0.001), with a higher prevalence of hypertension (71.0 vs. 56.5%, P < 0.001), insulin-treated diabetes (13.7 vs. 7.9%, P = 0.003), dyslipidemia (62.2 vs. 55.3%, P = 0.038), and chronic kidney disease (16.9 vs. 9.1%, P = 0.001). Women presented more frequently with back or arm pain radiation (57.3 vs. 49.7%, P = 0.025), palpitations (5.9 vs. 2.0%, P = 0.001), or dyspnea (33.0 vs. 19.4%, P = 0.001). ACS without significant coronary stenosis was more prevalent in women (16.8 vs. 8.1%, P = 0.001). There were no differences in percutaneous revascularization rates, but drug-eluting stents were less frequently employed in women (75.4 vs. 67.8%, P = 0.024); women were less often referred to a cardiac rehabilitation program (19.9 vs. 33.9%, P = 0.001). There were no significant differences in in-hospital complications such as thrombosis or bleeding. CONCLUSION ACS presenting with atypical symptoms and without significant coronary artery stenosis is more frequent in women. Selection of either an invasive procedure or conservative management is not influenced by sex. Cardiac rehabilitation referral on discharge is underused, especially in women.
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Affiliation(s)
| | | | - Belén Álvarez-Álvarez
- Servicio de Cardiología, Santiago de Compostela.,CIBER de enfermedades CardioVasculares (CIBERCV), Madrid
| | - Ruth Andrea
- Instituto Cardiovascular, Hospital Clinic, IDIBAPS, Universitat de Barcelona, Barcelona
| | | | - Jessika González-D'Gregorio
- CIBER de enfermedades CardioVasculares (CIBERCV), Madrid.,Servicio de Cardiología, Hospital Clínico Universitario, INCLIVA, Universidad de Valencia, Valencia
| | - Iván Hernández-Betancor
- Departamento de Cardiología, Complejo Hospitalario Universitario de Canarias, San Cristóbal de La Laguna
| | - José Rozado
- Área del Corazón, Hospital Universitario Central de Asturias, Oviedo
| | | | | | - Sandra Gómez-Talavera
- CIBER de enfermedades CardioVasculares (CIBERCV), Madrid.,IIS-Fundación Jiménez Díaz Hospital.,Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC)
| | - Juan Sanchís
- CIBER de enfermedades CardioVasculares (CIBERCV), Madrid.,Servicio de Cardiología, Hospital Clínico Universitario, INCLIVA, Universidad de Valencia, Valencia
| | | | | | - Borja Ibáñez
- CIBER de enfermedades CardioVasculares (CIBERCV), Madrid.,IIS-Fundación Jiménez Díaz Hospital.,Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC)
| | | | - José L Zamorano Gómez
- Servicio de Cardiología, Hospital Universitario Ramón y Cajal, Madrid.,Universidad de Alcalá, Hospital Universitario Ramón y Cajal.,Universidad Francisco de Vitoria, Hospital Universitario La Zarzuela, Madrid, Spain
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Anguita Sánchez M, Bertomeu Martínez V, Ruiz Ortiz M, Cequier Fillat Á, Roldán Rabadán I, Muñiz García J, Badimón Maestro L, Esteve Pastor MA, Marín Ortuño F. Direct oral anticoagulants versus vitamin K antagonists in real-world patients with nonvalvular atrial fibrillation. The FANTASIIA study. ACTA ACUST UNITED AC 2019; 73:14-20. [PMID: 31160265 DOI: 10.1016/j.rec.2019.02.021] [Citation(s) in RCA: 5] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Accepted: 02/14/2019] [Indexed: 11/18/2022]
Abstract
INTRODUCTION AND OBJECTIVES To compare the long-term results of direct oral anticoagulants (DOAC) vs vitamin K antagonists (VKA) in real-world-patients with nonvalvular atrial fibrillation (NVAF) in a nationwide, prospective study. METHODS The FANTASIIA registry prospectively included outpatients with AF anticoagulated with DOAC or VKA (per protocol, proportion of VKA and DOAC 4:1), consecutively recruited from June 2013 to October 2014 in Spain. The incidence of major events was analyzed and compared according to the anticoagulant treatment received. RESULTS A total of 2178 patients were included in the study (mean age 73.8±9.4 years), and 43.8% were women. Of these, 533 (24.5%) received DOAC and 1645 (75.5%) VKA. After a median follow up of 32.4 months, patients receiving DOAC vs those receiving VKA had lower rates of stroke-0.40 (95%CI, 0.17-0.97) vs 1.07 (95%CI,0.79-1.46) patients/y, P=.032-, severe bleedings-2.13 (95%CI, 1.45-3.13) vs 3.28 (95%CI, 2.75-3.93) patients/y; P = .044-, cardiovascular death-1.20 (95%CI, 0.72-1.99) vs 2.45 (95%CI, 2.00-3.00) patients/y; P = .009-, and all-cause death-3.77 (95%CI, 2.83-5.01) vs 5.54 (95%CI, 4.83-6.34) patients/y; P = .016-. In a modified Cox regression model by the Andersen-Gill method for multiple events, hazard ratios for patients receiving DOAC were: 0.42 (0.16-1.07) for stroke; 0.47 (0.20-1.16) for total embolisms; 0.76 (0.50-1.15) for severe bleedings; 0.67 (0.39-1.18) for cardiovascular death; 0.86 (0.62-1.19) for all-cause death, and 0.82 (0.64-1.05) for the combined event consisting of stroke, embolism, severe bleeding, and all-cause death. CONCLUSIONS Compared with VKA, DOAC is associated with a trend to a lower incidence of all major events, including death, in patients with NVAF in Spain.
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Affiliation(s)
| | | | - Martín Ruiz Ortiz
- Servicio de Cardiología, Hospital Universitario Reina Sofía, Córdoba, Spain
| | - Ángel Cequier Fillat
- Servicio de Cardiología, Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | | | | | - Lina Badimón Maestro
- Instituto de Investigación Cardiovascular (CSIC-ICCC)-Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - María Asunción Esteve Pastor
- Servicio de Cardiología, Hospital Universitario Virgen de la Arrixaca, IMIB-Arrixaca, CIBERCV, EL Palmar, Murcia, Spain
| | - Francisco Marín Ortuño
- Servicio de Cardiología, Hospital Universitario Virgen de la Arrixaca, IMIB-Arrixaca, CIBERCV, EL Palmar, Murcia, Spain
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Rodríguez-Padial L, Fernández Lozano I, Hidalgo Urbano R, Silva Melchor L, Evangelista Massip A, Anguita Sánchez M, Íñiguez Romo A. Trends and Bibliometric Impact of Research Grants of the Spanish Society of Cardiology/Spanish Heart Foundation (2007-2012). ACTA ACUST UNITED AC 2019; 72:1012-1019. [PMID: 30905664 DOI: 10.1016/j.rec.2018.08.029] [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] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Accepted: 08/24/2018] [Indexed: 11/18/2022]
Abstract
INTRODUCTION AND OBJECTIVES The Spanish Society of Cardiology/Spanish Heart Foundation (SEC/FEC) annually awards grants for cardiovascular research projects. Our objective was to analyze the trend in these investments and their resulting scientific production from 2007 to 2012. METHODS A search of the publications funded by the SEC/FEC was carried out, according to the following inclusion criteria: publication in a journal indexed in MEDLINE or EMBASE, publication date after the grant, authorship by the principal investigator of the grant, and acknowledgment of SEC/FEC funding. The impact factor and subsequent citations of the articles were analyzed (Web of Science). RESULTS A total of 235 grants were awarded (39/y) with an allocation of €3 854 300 (€642 383/y), 37% of them to women. In all, 122 publications resulted from 88 research projects (37%) funded by the SEC/FEC. Up to October 2017, these publications had received 2258 citations in subsequent studies in the Web of Science, with a mean of 18.5 and a median of 8 citations/study. CONCLUSIONS Despite the economic crisis, the mean number and size of the grants awarded by the SEC/FEC increased in the period analyzed. Grants were awarded on an equal opportunity basis to men and women. The bibliometric impact of the funded projects is acceptable, although efforts should be made to improve it.
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Affiliation(s)
| | | | - Rafael Hidalgo Urbano
- Servicio de Cardiología, Hospital Clínico Universitario Virgen Macarena, Sevilla, Spain
| | - Lorenzo Silva Melchor
- Servicio de Cardiología, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain
| | | | | | - Andrés Íñiguez Romo
- Servicio de Cardiología, Complejo Hospitalario Universitario Álvaro Cunqueiro, Vigo, Pontevedra, Spain
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Carnero Montoro L, Roldán Rabadán I, Marín Ortuño F, Bertomeu Martínez V, Muñiz García J, Anguita Sánchez M. Diferencias en las características y el tratamiento de los pacientes con fibrilación auricular seguidos por cardiólogos y por otros especialistas. Rev Esp Cardiol 2017. [DOI: 10.1016/j.recesp.2016.11.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Carnero Montoro L, Roldán Rabadán I, Marín Ortuño F, Bertomeu Martínez V, Muñiz García J, Anguita Sánchez M. Differences in the Characteristics and Management of Patients With Atrial Fibrillation Followed-up by Cardiologists and Other Specialists. Rev Esp Cardiol (Engl Ed) 2017; 70:883-886. [PMID: 28256334 DOI: 10.1016/j.rec.2016.11.038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Accepted: 11/14/2016] [Indexed: 06/06/2023]
Affiliation(s)
| | | | - Francisco Marín Ortuño
- Servicio de Cardiología, Hospital Clínico Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain
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Anguita Sánchez M, Castillo Domínguez JC. Do All Patients With Heart Failure Benefit From a Program for Early Follow-up After Hospital Discharge? Rev Esp Cardiol (Engl Ed) 2017; 70:624-625. [PMID: 28363706 DOI: 10.1016/j.rec.2017.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Accepted: 01/19/2017] [Indexed: 06/07/2023]
Affiliation(s)
- Manuel Anguita Sánchez
- Unidad de Insuficiencia Cardiaca, Servicio de Cardiología, Hospital Universitario Reina Sofía, Córdoba, Spain.
| | - Juan C Castillo Domínguez
- Unidad de Insuficiencia Cardiaca, Servicio de Cardiología, Hospital Universitario Reina Sofía, Córdoba, Spain
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Anguita Sánchez M, Castillo Domínguez JC. Seguimiento mediante programas específicos de consulta precoz tras el alta de un episodio de insuficiencia cardiaca: ¿en todos los pacientes? Rev Esp Cardiol (Engl Ed) 2017. [DOI: 10.1016/j.recesp.2017.01.013] [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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42
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Ramiro-Ortega E, Bonilla-Palomas JL, Gámez-López AL, Moreno-Conde M, López-Ibáñez MC, Alhambra-Expósito R, Anguita Sánchez M. Nutritional intervention in acute heart failure patients with undernutrition and normalbuminemia: A subgroup analysis of PICNIC study. Clin Nutr 2017; 37:1762-1764. [PMID: 28728683 DOI: 10.1016/j.clnu.2017.07.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Revised: 06/19/2017] [Accepted: 07/07/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND & AIMS Hypoalbuminemia is common in acute heart failure (HF) patients and has been associated with increased hospital mortality and long-term mortality. Undernutrition is a factor causing hypoalbuminemia. The PICNIC study results show that a nutritional intervention in undernourished acute HF patients reduces the risks of all-cause death and of readmission for HF. We aimed to investigate whether the efficacy of a nutritional intervention is consistent among the subgroups of patients with and without hypoalbuminemia. METHODS In PICNIC study, a total of 120 malnourished hospitalized patients due to acute HF were randomized to conventional HF treatment or conventional HF treatment combined with an individualized nutritional intervention. The primary endpoint was a composite of all-cause death or readmission for worsening of HF, with a maximum follow-up of 12 months. In this post-hoc sub-analysis we assessed the interaction of the effects of a nutritional intervention among patients with and without hypoalbuminemia. Analysis was by intention to treat. RESULTS 59 (49,2%) patients demonstrated hypoalbuminemia and 61 (50,8%) had normalbuminemia. At 12 months, the number of events for the primary endpoint in the intervention group compared with the control group was consistent among patients with hypoalbuminemia (28.6% intervention vs 61.3% control, HR 0,35, 95% CI 0,15-0,81) and those without (25.8% intervention vs 60% control, HR 0,35, 95% CI 0,15-0,79; interaction p = 0,86). CONCLUSION There was no evidence that the relative efficacy of a nutritional intervention in undernourished acute HF patients was different between patients with normalbuminemia and those with hypoalbuminemia.
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Affiliation(s)
| | | | | | - Mirian Moreno-Conde
- Department of Internal Medicine, Hospital San Juan de la Cruz, Úbeda, Jaén, Spain
| | - María C López-Ibáñez
- Department of Internal Medicine, Hospital San Juan de la Cruz, Úbeda, Jaén, Spain
| | - Rosa Alhambra-Expósito
- Department of Endocrinology and Nutrition, Hospital Universitario Reina Sofía, Córdoba, Spain
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Íñiguez Romo A, Bertomeu Martínez V, Rodríguez Padial L, Anguita Sánchez M, Ruiz Mateas F, Hidalgo Urbano R, Bernal Sobrino JL, Fernández Pérez C, Macaya de Miguel C, Elola Somoza FJ. Proyecto RECALCAR. La atención al paciente en las unidades de cardiología del Sistema Nacional de Salud, 2011-2014. Rev Esp Cardiol 2017. [DOI: 10.1016/j.recesp.2016.12.031] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Íñiguez Romo A, Bertomeu Martínez V, Rodríguez Padial L, Anguita Sánchez M, Ruiz Mateas F, Hidalgo Urbano R, Bernal Sobrino JL, Fernández Pérez C, Macaya de Miguel C, Elola Somoza FJ. The RECALCAR Project. Healthcare in the Cardiology Units of the Spanish National Health System, 2011 to 2014. ACTA ACUST UNITED AC 2017; 70:567-575. [PMID: 28457812 DOI: 10.1016/j.rec.2017.03.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Accepted: 01/18/2017] [Indexed: 12/15/2022]
Abstract
The RECALCAR project (Spanish acronym for Resources and Quality in Cardiology Units) uses 2 data sources: a survey of cardiology units and an analysis of the Minimum Basic Data set of all hospital discharges of the Spanish National Health System. From 2011 to 2014, there was marked stability in all indicators of the availability, utilization, and productivity of cardiology units. There was significant variability between units and between the health services of the autonomous communities. There was poor implementation of process management (only 14% of the units) and scarce development of health care networks (17%). Structured cardiology units tended to have better results, in terms of both quality and efficiency. No significant differences were found between the different types of unit in the mean length of stay (5.5±1.1 days) or the ratio between successive and first consultations (2:1). The mean discharge rate was 5/1000 inhabitants/y and the mean rate of initial consultations was 16±4/1000 inhabitants/y. No duty or on-call cardiologist was available in 30% of cardiology units with 24 or more beds; of these, no critical care beds were available in 45%. Our findings support the recommendation to regionalize cardiology care and to promote the development of cardiology unit networks.
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Affiliation(s)
- Andrés Íñiguez Romo
- Servicio de Cardiología, Complejo Hospitalario Universitario de Vigo, Vigo, Pontevedra, Spain
| | | | | | | | | | - Rafael Hidalgo Urbano
- Unidad de Gestión Clínica de Cardiología y Cirugía Cardiovascular, Hospital Universitario Virgen Macarena, Sevilla, Spain
| | | | - Cristina Fernández Pérez
- Unidad Transversal de Apoyo a la Investigación, Hospital Clínico Universitario San Carlos, Madrid, Spain
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Anguita Sánchez M, Castro Conde A, Cordero Fort A, García-Moll Marimón X, Gómez Doblas JJ, González-Juanatey JR, Lidón Corbi RM, López-Sendón JL, Mostaza Prieto J, Rodríguez Padial L. Necesidades no cubiertas con el tratamiento hipolipemiante oral: documento de posición de la Sociedad Española de Cardiología. Rev Esp Cardiol 2016. [DOI: 10.1016/j.recesp.2016.05.013] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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46
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Anguita Sánchez M, Castro Conde A, Cordero Fort A, García-Moll Marimón X, Gómez Doblas JJ, González-Juanatey JR, Lidón Corbi RM, López-Sendón JL, Mostaza Prieto J, Rodríguez Padial L. Challenges in Oral Lipid-lowering Therapy: Position Document of the Spanish Society of Cardiology. ACTA ACUST UNITED AC 2016; 69:1083-1087. [PMID: 27650859 DOI: 10.1016/j.rec.2016.05.033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Accepted: 05/31/2016] [Indexed: 11/30/2022]
Abstract
Lipid-lowering therapy is one of the cornerstones of cardiovascular prevention and is one of the most effective strategies in the secondary prevention of ischemic heart disease. Nevertheless, the current treatment of lipid disorders, together with lifestyle changes, fails to achieve the targets recommended in clinical guidelines in a substantial proportion of patients. PCSK9 inhibitors have demonstrated safety and efficacy in the treatment of dyslipidemia. Due to their ability to reduce low-density lipoprotein cholesterol levels, these drugs have recently been approved for clinical use by Spanish regulatory agencies, with the aim of reducing cardiovascular risk in selected patient groups.
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Affiliation(s)
| | | | - Alberto Cordero Fort
- Servicio de Cardiología, Hospital Universitario de San Juan, San Juan de Alicante, Alicante, Spain
| | | | | | - José R González-Juanatey
- Servicio de Cardiología, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain.
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Nieto A, Sánchez MA, Martínez E, Rollán E. Immunohistochemical Expression of p53, Fibroblast Growth Factor-b, and Transforming Growth Factor-α in Feline Vaccine-associated Sarcomas. Vet Pathol 2016; 40:651-8. [PMID: 14608018 DOI: 10.1354/vp.40-6-651] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Fifty feline sarcomas associated with vaccine-site injection were evaluated to determine the immunohistochemical expression of p53 protein, basic fibroblast growth factor (FGF-b), and transforming growth factor-α (TGF-α). Forty-one tumors (82%) were fibrosarcomas (FS), eight (16%) were malignant fibrous histiocytomas (MFH), and one (2%) was a chondrosarcoma (CS). Overexpression of p53 protein was observed in the nuclei of tumor cells in 28 (56%) sarcomas; FGF-b expression was found in the cytoplasm of tumor cells in 40 (80%) feline sarcomas, but the staining was more intense in the spindle-shaped cells of FS than in polygonal or round cells of MFH. The single CS faintly expressed FGF-b. The majority of feline vaccine-associated sarcomas (43 of 50, 86%) expressed moderate or intense staining for TGF-α in the cytoplasm of tumor cells. Heterogeneous immunolabeling for p53, FGF-b, and TGF-α was present in neoplastic, multinucleated giant cells. Intense expression of FGF-b was statistically associated with younger cats ( P < 0.01) and with tumors with nodular growth patterns ( P = 0.02). In addition, sarcomas negative for p53 protein expressed FGF-b more frequently than did p53-positive tumors ( P = 0.04). The frequency of FGF-b immunostaining was significantly higher in sarcomas with intense expression of TGF-α ( P = 0.05). Immunohistochemical detection of p53 protein, FGF-b, and TGF-α suggests that these growth-regulating proteins may play different roles in the development of sarcomas associated with vaccine sites.
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Affiliation(s)
- A Nieto
- Departamento de Patología Animal II, Facultad de Veterinaria, Universidad Complutense de Madrid, 28040 Madrid, Spain
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Anguita Sánchez M, Bertomeu Martínez V, Cequier Fillat A. Grado de control de la anticoagulación en pacientes con fibrilación auricular en España: necesidad de minimizar sesgos y contextualizar resultados. Respuesta de Anguita Sánchez et al. Rev Esp Cardiol (Engl Ed) 2016. [DOI: 10.1016/j.recesp.2015.11.018] [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: 10/22/2022]
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Roldán Rabadán I, Anguita Sánchez M, Marín F, Quesada MA, Camacho Siles J, Peinado R, Bertomeu V, Cequier Fillat Á, Badimón L, Muñiz J. Tratamiento antiarrítmico actual de la fibrilación auricular no valvular en España. Datos del Registro FANTASIIA. Rev Esp Cardiol 2016. [DOI: 10.1016/j.recesp.2015.03.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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50
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Anguita Sánchez M, Bertomeu Martínez V, Cequier Fillat Á. Insuficiencia cardiaca, fibrilación auricular no valvular y control de la anticoagulación con antagonistas de la vitamina K. Rev Esp Cardiol 2016. [DOI: 10.1016/j.recesp.2015.08.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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