Revista clinica espanola最新文献

{"title":"Características, tratamiento y pronóstico a 1 año de los pacientes con insuficiencia cardíaca y enfermedad renal crónica estadios 4 o 5","authors":"M. Anguita-Gámez,&nbsp;J.L. Bonilla-Palomas,&nbsp;A. Esteban-Fernández,&nbsp;A. Recio-Mayoral,&nbsp;J. Muñiz,&nbsp;R. González-Manzanares,&nbsp;M. Ruiz-Ortiz,&nbsp;M. Anguita-Sánchez,&nbsp;D. Mesa-Rubio","doi":"10.1016/j.rce.2026.502578","DOIUrl":"10.1016/j.rce.2026.502578","url":null,"abstract":"<div><h3>Aims</h3><div>To analyze, in a contemporary registry of patients with heart failure (HF), the differences in characteristics, treatment, and 1-year prognosis between patients with chronic kidney disease (CKD) stages<!--> <!-->4-5 versus CKD<!--> <!-->1-3.</div></div><div><h3>Methods</h3><div>We analyzed the SEC-Excelente-HF registry of the Spanish Society of Cardiology, that included 2,245 patients between 2018 and 2023 by 68 HF units. Characteristics, treatment, mortality, and hospitalization rates for HF at 1<!--> <!-->year were compared between patients with an estimated glomerular filtration rate (eGFR) &lt;<!--> <!-->30<!--> <!-->ml/minute/m² and those with an eGFR ≥<!--> <!-->30<!--> <!-->ml/min/m².</div></div><div><h3>Results</h3><div>Of the 2,245 patients, 9.9% had CKD 4-5 and 90.1% had an eGFR ≥<!--> <!-->30<!--> <!-->ml/min/m². Ejection fraction was similar (42.8<!--> <!-->±<!--> <!-->15.4 vs. 40.3<!--> <!-->±<!--> <!-->15.3%). The CKD<!--> <!-->4-5 group was older (76.9<!--> <!-->±<!--> <!-->9.6 vs. 70.5<!--> <!-->±<!--> <!-->12.4 years; <em>P</em> <!-->&lt;<!--> <!-->.001) and showed a higher prevalence of ischemic heart disease, diabetes mellitus, anemia, and iron deficiency. These patients received in a lower proportion all drugs for HF (<em>P</em> <!-->&lt;<!--> <!-->.001), except diuretics and potassium binders. Mortality rate (36.1 vs. 14.6/100 person-years; <em>P</em> <!-->&lt;<!--> <!-->.001) and the rate of HF hospitalizations at one year (67.3 vs. 30.9/100 person-years; <em>P</em> <!-->&lt;<!--> <!-->.001) were higher in patients with CKD stages<!--> <!-->4-5.</div></div><div><h3>Conclusions</h3><div>In a contemporary cohort of patients with HF, patients with CKD stages<!--> <!-->4-5 had different clinical characteristics, received in a lesser proportion adequate treatment, and had higher 1-year mortality and HF hospitalization rates.</div></div>","PeriodicalId":21223,"journal":{"name":"Revista clinica espanola","volume":"226 7","pages":"Article 502578"},"PeriodicalIF":1.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148651701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efecto protector de la vacunación antineumocócica en la evolución de la neumonía neumocócica: análisis ajustado por gravedad y comorbilidad","authors":"J.M. Moreno Salcedo,&nbsp;P. Malo Rico,&nbsp;G. Alcalá Rivera,&nbsp;M.F. Rueda Narváez","doi":"10.1016/j.rce.2026.502575","DOIUrl":"10.1016/j.rce.2026.502575","url":null,"abstract":"<div><h3>Background and objective</h3><div>Pneumococcal vaccination may attenuate the severity of pneumococcal pneumonia even in breakthrough infections. However, evidence on this effect stratified by clinical severity is scarce. The objective was to evaluate whether vaccination reduces poor outcomes in patients hospitalized for pneumococcal pneumonia, specifically according to CURB-65 severity.</div></div><div><h3>Methods</h3><div>Retrospective observational study of 90 adults with microbiologically confirmed pneumococcal pneumonia (January 2020–December 2024). Poor outcome was defined as death or ICU admission. Propensity score matching (PSM) 1:1 was performed to control for indication bias, adjusting for age, sex, comorbidity, CURB-65, and dependency. In the matched sample (43 pairs), the effect of vaccination on poor outcome was analysed with logistic regression further adjusted for comorbidity and CURB-65. Sensitivity analysis was conducted with inverse probability of treatment weighting (IPTW).</div></div><div><h3>Results</h3><div>Vaccinated patients had higher age, comorbidity, and CURB-65 at admission. PSM achieved adequate balance between groups. In the matched sample, poor outcome occurred in 34.9% of vaccinated and 51.2% of unvaccinated (absolute reduction 16.3%). Adjusted OR for vaccination was 0.42 (95% CI: 0.16-1.07; <em>P</em>=.070), suggesting a possible protective effect, although statistical significance was not reached. CURB-65 was an independent predictor of poor outcome (OR per point: 1.93; <em>P</em>=.006). IPTW yielded an OR of 1.28 (95% CI: 0.67-2.47; <em>P</em>=.46).</div></div><div><h3>Conclusions</h3><div>Pneumococcal vaccination shows a possible protective effect, with a trend toward clinically relevant benefit, especially in patients with more severe disease (CURB-65 ≥3), reducing poor outcomes by 16.3%. This finding supports vaccination in adults with risk factors.</div></div>","PeriodicalId":21223,"journal":{"name":"Revista clinica espanola","volume":"226 7","pages":"Article 502575"},"PeriodicalIF":1.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148652141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Valor pronóstico de la escala National Early Warning Score 2 (NEWS-2) en la atención urgente de pacientes mayores de 80 años con infección: estudio observacional","authors":"M. Perea Gainza,&nbsp;M.A. Arce Marañón,&nbsp;N. Miota Hernández,&nbsp;D. Sempertegui Gutiérrez,&nbsp;M. Carbó Díez,&nbsp;G. Osorio Quispe,&nbsp;L. Artajona García,&nbsp;C. Piñol Bel,&nbsp;M.J. Castaño Suero,&nbsp;C. Rangel Falcón,&nbsp;G. Benedetti,&nbsp;M.M. Ortega Romero","doi":"10.1016/j.rce.2026.502574","DOIUrl":"10.1016/j.rce.2026.502574","url":null,"abstract":"<div><h3>Introduction</h3><div>Prognostic stratification of very elderly patients with infection presenting to the emergency department remains challenging. The <em>National Early Warning Score</em> <em>2</em> (NEWS-2) is widely used to identify the risk of clinical deterioration; however, its prognostic performance in patients aged 80<!--> <!-->years or older has been insufficiently evaluated.</div></div><div><h3>Objective</h3><div>To assess the prognostic value of NEWS-2 for in-hospital mortality in patients aged ≥<!--> <!-->80<!--> <!-->years presenting to the emergency department with infection who receive antibiotic therapy and require hospital admission.</div></div><div><h3>Methods</h3><div>We conducted a retrospective observational study in an emergency department during 2022. Patients aged ≥<!--> <!-->80<!--> <!-->years with infection, initiation of antibiotic therapy in the emergency department, and subsequent hospital admission were included. Collected variables comprised comorbidity (Charlson Comorbidity Index), functional status (Barthel Index), frailty (Clinical Frailty Scale), and NEWS-2 at admission. The primary outcome was in-hospital mortality. Multivariate logistic regression analysis and assessment of discriminatory performance were performed.</div></div><div><h3>Results</h3><div>A total of 987 patients were included (mean age 87<!--> <!-->years; 53% women). In-hospital mortality was 13%. NEWS-2 was independently associated with mortality (OR: 1.30; 95%<!--> <!-->CI: 1.22-1.37). The area under the receiver operating characteristic curve was 0.748 (95%<!--> <!-->CI: 0.698-0.797). A NEWS-2 cut-off value of ≥<!--> <!-->8 showed a sensitivity of 54% and a specificity of 85%, with adequate model calibration.</div></div><div><h3>Conclusions</h3><div>NEWS-2 demonstrates moderate prognostic accuracy for in-hospital mortality in patients aged ≥<!--> <!-->80<!--> <!-->years with infection attended in the emergency department who require hospital admission, and may provide complementary information to support clinical decision-making in this population.</div></div>","PeriodicalId":21223,"journal":{"name":"Revista clinica espanola","volume":"226 7","pages":"Article 502574"},"PeriodicalIF":1.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148652140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enfermedad de Alzheimer y enfermedad periodontal: revelando la asociación mediante una revisión sistemática y un metaanálisis","authors":"F.M. Ridho ,&nbsp;A. Irmawati ,&nbsp;A.P. Wicaksana ,&nbsp;R. Alfatah ,&nbsp;R. Labib","doi":"10.1016/j.rce.2026.502545","DOIUrl":"10.1016/j.rce.2026.502545","url":null,"abstract":"<div><h3>Objective</h3><div>This meta-analysis aimed to determine the association between periodontal disease (PD) and Alzheimer's disease (AD).</div></div><div><h3>Methods</h3><div>Observational studies reporting the association between PD and AD published from inception to March 2025 in PubMed, Scopus, EBSCO, ScienceDirect, Web of Science, and CENTRAL were searched. The ROBINS-I tool was used for risk of bias assessment. Meta-analysis was performed using a random-effects model and presented as odds ratio (OR) with 95% confidence interval (CI). Analyses were run using Review Manager 5.4.</div></div><div><h3>Results</h3><div>Six studies (n<!--> <!-->=<!--> <!-->291,057 participants) met the inclusion criteria. Pooled analysis showed a significant association between PD and AD (OR<!--> <!-->=<!--> <!-->2.67; 95% CI: 1.41-5.06; p<!--> <!-->=<!--> <!-->0.003; I² <!-->=<!--> <!-->92%). Sensitivity analysis showed a consistent direction of association. The substantial heterogeneity likely reflects differences in study design and confounder adjustment across studies.</div></div><div><h3>Conclusions</h3><div>This study indicates a potential association between PD and AD. However, given the limited number of studies, substantial heterogeneity, and the possibility of residual confounding, the pooled estimate should be interpreted with caution. Well-designed prospective and interventional studies are needed to clarify the potential causality.</div></div>","PeriodicalId":21223,"journal":{"name":"Revista clinica espanola","volume":"226 6","pages":"Article 502545"},"PeriodicalIF":1.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148146570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neumonía adquirida en la comunidad: evaluación de la adecuación terapéutica en pacientes ingresados en un hospital de segundo nivel","authors":"A. Silva Asiain ,&nbsp;M. Arrondo Turrado ,&nbsp;M.A. Domínguez Sepúlveda ,&nbsp;P. Bermejo Acevedo ,&nbsp;R. Barba Martín ,&nbsp;J.A. Rueda Camino","doi":"10.1016/j.rce.2026.502563","DOIUrl":"10.1016/j.rce.2026.502563","url":null,"abstract":"<div><h3>Background</h3><div>There is limited evidence regarding the appropriateness of therapeutic management for community-acquired pneumonia (CAP) in Spain. This study assessed treatment adequacy according to the 2019 IDSA guidelines.</div></div><div><h3>Materials and methods</h3><div>Retrospective cohort study involving adults hospitalized for CAP between January-December 2022, excluding nosocomial pneumonia and ICU admissions. Treatment was considered adequate if antibiotic type, duration, and dosage were appropriate. The primary outcome was the proportion of patients receiving adequate treatment. Secondary outcomes included length of stay and hospital costs.</div></div><div><h3>Results</h3><div>382 patients (50% male, mean age 74.24<!--> <!-->±<!--> <!-->16.62 years) were included; 17.8% (95%<!--> <!-->CI: 14.1%-22.0%) received adequate treatment. Patients with adequate treatment exhibited a significantly shorter hospital stay (−1<!--> <!-->day; 95%<!--> <!-->CI: −1.7 to −0.3) and significantly lower hospital costs (−545€; 95%<!--> <!-->CI: −1081€ to −9€).</div></div><div><h3>Conclusion</h3><div>Therapeutic adequacy among hospitalized patients with CAP is low.</div></div>","PeriodicalId":21223,"journal":{"name":"Revista clinica espanola","volume":"226 6","pages":"Article 502563"},"PeriodicalIF":1.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148146657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Asociación de bronquio traqueal y enfisema segmentario congénito en un paciente adulto","authors":"L. Gorospe ,&nbsp;R.M. Mirambeaux-Villalona ,&nbsp;A. González-Huete","doi":"10.1016/j.rce.2026.502569","DOIUrl":"10.1016/j.rce.2026.502569","url":null,"abstract":"","PeriodicalId":21223,"journal":{"name":"Revista clinica espanola","volume":"226 6","pages":"Article 502569"},"PeriodicalIF":1.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148146659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Actividad del internista en la asistencia al paciente oncológico en España en 2025","authors":"A. García-Villa ,&nbsp;J. Marco-Hernández ,&nbsp;C. Macía-Rodríguez ,&nbsp;P. Villacé Gallego ,&nbsp;C. Heredia-Mena ,&nbsp;M. Viladot ,&nbsp;L. Medina Ortega ,&nbsp;E.P. Fernández-Fernández ,&nbsp;E. Montero-Ruiz ,&nbsp;F.J. Teigell-Muñoz","doi":"10.1016/j.rce.2026.502544","DOIUrl":"10.1016/j.rce.2026.502544","url":null,"abstract":"<div><h3>Introduction</h3><div>The prevalence of cancer has increased, together with greater patient complexity. In this context, the involvement of internists in the care of patients with solid tumors has grown in recent years. The aim of this study is to describe the activity of internists in the care of patients with cancer in Spain.</div></div><div><h3>Materials and methods</h3><div>A cross-sectional study based on a cohort comprising all public hospitals and the main private hospitals of Spain was performed. Information was collected through a survey completed by internists and oncologists in January and February 2025.</div></div><div><h3>Results</h3><div>Responses were obtained from 188 of the 481 hospitals (39.1%), representing 51.2% of public centers and 16.7% of private ones. In 181 centers, patients with cancer were admitted for inpatient care; this responsibility fell to Department of Oncology in 56.4% of centers and to Department of Internal Medicine in 43.6%. Among centers where patients were admitted under Department of Oncology an internist was part of the inpatient ward team (“co-management” model) in 37.3% of cases. Overall, in 64.5% of centers, oncology patients were admitted to wards staffed by internists, either through direct Internal Medicine care or through the “co-management” model.</div></div><div><h3>Conclusion</h3><div>Internists play a key role in the care of oncology patients in Spain, particularly in inpatient wards. The widespread involvement of internists supports recognizing this work as a structural component of oncology patient care, as well as their active participation in multidisciplinary teams.</div></div>","PeriodicalId":21223,"journal":{"name":"Revista clinica espanola","volume":"226 6","pages":"Article 502544"},"PeriodicalIF":1.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148146568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Resumen ejecutivo del documento de consenso sobre el manejo de la transición de pacientes con errores innatos del metabolismo intermediario","authors":"M.Á. Martínez Olmos ,&nbsp;C. Alcalde-Martín ,&nbsp;A. Bélanger-Quintana ,&nbsp;R. Burgos Peláez ,&nbsp;J. de las Heras ,&nbsp;M. del Toro ,&nbsp;M. Forga Visa ,&nbsp;A. Moráis-López ,&nbsp;M. Morales-Conejo ,&nbsp;E. Venegas-Moreno ,&nbsp;I. Vitoria Miñana","doi":"10.1016/j.rce.2026.502548","DOIUrl":"10.1016/j.rce.2026.502548","url":null,"abstract":"<div><div>Inborn errors of intermediary metabolism (IEiM) are rare genetic diseases with significant morbidity and mortality, requiring complex and continuous management throughout life. To ensure continuity of care and improve patient outcomes and quality of life, a transition from paediatric to adult care must be made. However, this transition is not standardised, and its current status in Spain is unknown. In this study, 11 experts in IEiM (Endocrinology and Nutrition, Paediatrics, Internal Medicine, Paediatric Neurology) developed questions and statements to validate in a survey based on the Delphi method, where 25 experts participated. Data from current clinical practice in Spain were obtained regarding patients with IEiM and their transition, with 68% of participants reporting that up to 25% of patients who should be managed as adults receive care in Paediatrics. Subsequently, we proposed 24 recommendations to improve the transition of patients with IEiM.</div></div>","PeriodicalId":21223,"journal":{"name":"Revista clinica espanola","volume":"226 6","pages":"Article 502548"},"PeriodicalIF":1.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148146577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bacteriemias polimicrobianas: análisis clínico y microbiológico en un hospital universitario español","authors":"R. Causa ,&nbsp;M.C. García ,&nbsp;G. Santillana ,&nbsp;Y. Angulo ,&nbsp;V. Marín ,&nbsp;L. Grau ,&nbsp;F. Ríos ,&nbsp;M. Andrés","doi":"10.1016/j.rce.2026.502566","DOIUrl":"10.1016/j.rce.2026.502566","url":null,"abstract":"<div><h3>Background and objectives</h3><div>Evidence on polymicrobial bloodstream infections (PMB) in Spain remains limited. In this study, we aimed to describe its etiology, clinical features and outcomes in adult patients.</div></div><div><h3>Methods</h3><div>A retrospective observational study was conducted at a 350-bed hospital in Terrassa, Barcelona, from 2017 to 2024. Clinical and microbiological data were reviewed. Bivariate analyses and multivariate logistic regression were applied to identify predictors of 30-day mortality.</div></div><div><h3>Results</h3><div>We identified 115 episodes. Intra-abdominal foci represented 50% of cases. Non-anaerobic Gram-negative bacilli predominated, either alone (31%) or combined with Gram-positive cocci (40%), while anaerobes appeared in 14%. Thirty-day mortality was 30%. In the multivariable analysis, three variables remained independently associated with mortality: baseline prognosis (McCabe-score), acute severity (Pitt bacteremia-score) and adequacy of empirical therapy.</div></div><div><h3>Conclusions</h3><div>PMB is associated with high mortality. Prognosis is influenced by host vulnerability, infection severity and the initial empirical treatment. Early recognition and adequate empirical therapy are essential to improve outcomes.</div></div>","PeriodicalId":21223,"journal":{"name":"Revista clinica espanola","volume":"226 6","pages":"Article 502566"},"PeriodicalIF":1.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148146658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estudio observacional de práctica clínica real para evaluar la efectividad y la seguridad de los anticoagulantes orales de acción directa en comparación con antagonistas de la vitamina K en la prevención secundaria de la trombosis venosa en pacientes con síndrome antifosfolipídico trombótico de bajo riesgo. Protocolo del estudio DOACS-APS","authors":"I. Perales Fraile ,&nbsp;M. Martín Asenjo ,&nbsp;C.L. de Ancos Aracil ,&nbsp;J. Torres Macho ,&nbsp;L. Sáez Comet ,&nbsp;M. Martín Cascón ,&nbsp;J. Alijotas Reig ,&nbsp;A. González García ,&nbsp;A. Franco Moreno","doi":"10.1016/j.rce.2026.502564","DOIUrl":"10.1016/j.rce.2026.502564","url":null,"abstract":"<div><h3>Background</h3><div>The therapeutic management of thrombotic antiphospholipid syndrome (APS) is based on indefinite anticoagulation. Vitamin<!--> <!-->K antagonists (VKA) remain the standard of care, particularly in patients with triple antiphospholipid antibody positivity or a history of arterial thrombosis. In low-risk patients, defined as those with single or double antiphospholipid antibody positivity and no prior arterial thrombosis, recent data suggest that direct oral anticoagulants (DOAC) may provide efficacy comparable to VKA. However, the quality of the available evidence is moderate to low. This study aims to compare the effectiveness of DOAC versus VKA in preventing thrombotic recurrence in low-risk patients with APS.</div></div><div><h3>Methods</h3><div>This is a multicentre, ambispective, observational, analytical study conducted in Internal Medicine departments across Spanish hospitals. Adult patients with low-risk thrombotic APS treated with DOAC or VKA will be included and followed for a minimum of two years. The primary effectiveness outcome will be venous thrombotic recurrence.</div></div><div><h3>Conclusions</h3><div>The DOACS-APS study will provide clinically relevant real-world evidence on the effectiveness of DOAC in a selected subgroup of patients with APS, thereby improving therapeutic decision-making in routine clinical practice.</div><div>The study is registered at ClinicalTrials.gov (NCT07372170).</div></div>","PeriodicalId":21223,"journal":{"name":"Revista clinica espanola","volume":"226 6","pages":"Article 502564"},"PeriodicalIF":1.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148146576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}