Revista espanola de cardiologia最新文献

{"title":"Therapy (I)","authors":"Fernando A. Navarro","doi":"10.1016/j.recesp.2026.01.002","DOIUrl":"10.1016/j.recesp.2026.01.002","url":null,"abstract":"","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":"79 7","pages":"Page 581"},"PeriodicalIF":4.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148544291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"¿Lo que no te mata te hace más fuerte?","authors":"Héctor M. García-García, Pablo Rubio, Mauro Echavarría-Pinto","doi":"10.1016/j.recesp.2025.12.016","DOIUrl":"10.1016/j.recesp.2025.12.016","url":null,"abstract":"","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":"79 7","pages":"Pages 603-605"},"PeriodicalIF":4.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148544290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estratificación pronóstica de pacientes con enfermedad coronaria no obstructiva tratados según pruebas invasivas de función coronaria","authors":"Eva Rumiz,&nbsp;Georgina Fuertes,&nbsp;Ainhoa Pérez,&nbsp;Guillem Llopis,&nbsp;Luis Cerdán,&nbsp;Pablo Vadillo,&nbsp;Alberto Carrión,&nbsp;Isabel Ezpeleta,&nbsp;Cristina Buisán,&nbsp;Sonia Cardona,&nbsp;Ernesto Valero,&nbsp;Javier Escaned,&nbsp;Julio Núñez","doi":"10.1016/j.recesp.2025.11.011","DOIUrl":"10.1016/j.recesp.2025.11.011","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Angina or myocardial ischemia with nonobstructive coronary artery disease (ANOCA/INOCA) is associated with an elevated risk of adverse outcomes. This study aimed to evaluate the prognosis of patients with ANOCA/INOCA who received tailored therapy according to their endotype, as defined by invasive coronary function testing (CFT).</div></div><div><h3>Methods</h3><div>This prospective, multicenter observational study included ANOCA/INOCA patients who underwent an invasive CFT. The primary outcome was a composite of total episodes of myocardial infarction, emergency department visits for chest pain, or hospital admissions for angina or heart failure that occurred during a long-term follow-up. Negative binomial regression was used to assess the association between endotypes and total events, with risk estimates expressed as incidence rate ratios (IRR).</div></div><div><h3>Results</h3><div>From January 2020 to November 2023, a total of 308 patients were enrolled. Patients were stratified into 4 endotypes: microvascular dysfunction (n<!--> <!-->=<!--> <!-->141), epicardial spasm (n<!--> <!-->=<!--> <!-->66), microvascular spasm (n<!--> <!-->=<!--> <!-->26), or negative-CFT (n<!--> <!-->=<!--> <!-->75). At a median follow-up of 1.8 years, the incidence rates of the composite outcome per 100 patient-years were 35.3, 12.9, 31.0, and 10.2 in microvascular dysfunction, epicardial spasm, microvascular spasm, and negative-CFT endotypes, respectively (<em>P</em> &lt;<!--> <!-->.001). After multivariable adjustment, microvascular dysfunction emerged as the only independent predictor of the composite outcome (IRR, 3.24; 95%CI, 1.12-9.05; <em>P</em> <!-->=<!--> <!-->.029).</div></div><div><h3>Conclusions</h3><div>Despite tailored medical therapy, ANOCA/INOCA endotype classification revealed significant prognostic differences, with microvascular dysfunction being the endotype associated with the highest burden of recurrent events<strong>.</strong></div></div>","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":"79 7","pages":"Pages 593-602"},"PeriodicalIF":4.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148544292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implicaciones pronósticas de la disfunción microvascular coronaria en el IAMCEST con y sin síndrome metabólico","authors":"Qian Guo,&nbsp;Yingying Guo,&nbsp;Shutian Shi,&nbsp;Hui Wang,&nbsp;Bin Que,&nbsp;Lei Xu,&nbsp;Hongtao Liu,&nbsp;Shaoping Nie,&nbsp;Deyong Long,&nbsp;Xiao Wang","doi":"10.1016/j.recesp.2025.11.020","DOIUrl":"10.1016/j.recesp.2025.11.020","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Metabolic syndrome (MetS) is associated with coronary microvascular dysfunction (CMD), both of which increase the risk of cardiovascular events after ST-segment elevation myocardial infarction (STEMI). However, the prognostic significance of CMD in STEMI patients with MetS remains unclear. This study aimed to evaluate the effects of CMD, assessed by the angiography-derived index of microcirculatory resistance, on cardiovascular outcomes in STEMI patients with and without MetS.</div></div><div><h3>Methods</h3><div>STEMI patients undergoing primary percutaneous coronary intervention were prospectively enrolled at 4 centers. MetS was defined as the presence of at least 3 out of 5 cardiometabolic abnormalities. CMD was defined as an angiography-derived index of microcirculatory resistance<!--> <!-->&gt; 40 U.</div></div><div><h3>Results</h3><div>Among 497 included patients, 316 (63.8%) patients had MetS. During 2.8 years follow-up, the cumulative incidence of adverse outcomes was significantly higher in the CMD group than in the non-CMD group among patients with MetS (30.3% vs 18.4%; <em>P</em> <!-->=<!--> <!-->.034), but not among those without MetS (12.6% vs 13.0%; <em>P</em> <!-->=<!--> <!-->.937). Both the presence of CMD and the angiography-derived index of microcirculatory resistance as a continuous variable predicted adverse outcomes in patients with MetS, but not in those without MetS. CMD was also significantly associated with left ventricular dysfunction (OR, 3.909; 95%<span>C</span>I, 1.330-11.489; <em>P</em> <!-->=<!--> <!-->.013) and lack of left ventricular ejection fraction recovery (OR, 3.367; 95%CI, 1.099-10.318; <em>P</em> <!-->=<!--> <!-->.034) at follow-up, independently of baseline function.</div></div><div><h3>Conclusions</h3><div>CMD assessed by the angiography-derived index of microcirculatory resistance independently predicts adverse outcomes and lack of left ventricular functional recovery in STEMI patients with MetS, but not in those without MetS.</div></div>","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":"79 7","pages":"Pages 606-617"},"PeriodicalIF":4.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148544293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictores de mal pronóstico en una extensa cohorte de pacientes con amiloidosis cardiaca hereditaria por transtirretina","authors":"Tomás Ripoll-Vera,&nbsp;Fernando de Frutos,&nbsp;José González-Costello,&nbsp;Ana José Manovel-Sánchez,&nbsp;Esther Zorio-Grima,&nbsp;M. Teresa Bosch-Rovira,&nbsp;José Manuel García-Pinilla,&nbsp;María Robledo-Iñarritu,&nbsp;Javier Limeres-Freire,&nbsp;Ana García-Álvarez,&nbsp;María Gallego-Delgado,&nbsp;María Ángeles Espinosa-Castro,&nbsp;José López-Aguilera,&nbsp;Rosa Macías-Ruiz,&nbsp;María Valverde-Gómez,&nbsp;Xabier Arana-Achaga,&nbsp;Ana Isabel Rodríguez-Serrano,&nbsp;Edgardo Alania-Torres,&nbsp;José Ángel Urbano-Moral,&nbsp;José M. Larrañaga-Moreira,&nbsp;Jorge Álvarez-Rubio","doi":"10.1016/j.recesp.2025.12.013","DOIUrl":"10.1016/j.recesp.2025.12.013","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Hereditary transthyretin amyloidosis (hATTR) is a rare, multisystemic, autosomal dominant disease. Cardiac involvement worsens prognosis. We aimed to characterize Spanish patients with hATTR cardiac amyloidosis (hATTR-CA) and to identify predictors of poor prognosis.</div></div><div><h3>Methods</h3><div>We conducted a retrospective, multicenter study in 39 Spanish hospitals, including adults with genetically confirmed hATTR and cardiac involvement (January 2000-September 2022). Independent predictors of poor prognosis (death, heart transplantation, heart failure, or cardiovascular hospitalization) were identified using multivariate logistic regression. Data were also collected on clinical and genetic characteristics, management patterns, and event-free survival.</div></div><div><h3>Results</h3><div>A total of 442 patients were included (67.6% male; median age at diagnosis, 65 years). Fifteen <em>TTR</em> variants were identified, with p.Val30Met being the most frequent (64.9%). The most common extracardiac manifestation was neuropathy (64.6%). At baseline, most patients were in New York Heart Association class I-II, with progressive worsening during follow-up. Overall, 48.9% of patients were hospitalized, and 21.9% died; 25.3% of deaths were heart failure-related. Five-year event-free survival was 80.2% from symptom onset and 66.9% from diagnosis. Disease-specific treatments (tafamidis, patisiran, inotersen, or liver transplant) were associated with improved survival (<em>P</em> &lt;<!--> <!-->.001). In an exploratory analysis stratified by diagnosis before vs after 2018, event-free survival did not differ significantly (HR, 1.04; 95%CI, 0.63-1.72; <em>P</em> <!-->=<!--> <!-->.88). Independent predictors of poor prognosis included New York Heart Association class II-IV, lower left ventricular ejection fraction, elevated N-terminal pro-B-type natriuretic peptide, and the presence of neurological involvement.</div></div><div><h3>Conclusions</h3><div>This national cohort—the largest reported to date—highlights the clinical and genetic heterogeneity of hATTR -CA in Spain. Early diagnosis and disease-specific therapies are essential to improving prognosis.</div><div><em>Full English text available from</em>:<span><span>www.revespcardiol.org/en</span><svg><path></path></svg></span></div></div>","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":"79 7","pages":"Pages 618-630"},"PeriodicalIF":4.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148544294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aneurisma septal disecante como complicación de una fístula coronaria","authors":"Leizhi Ku,&nbsp;Di Zhou,&nbsp;Xiaojing Ma","doi":"10.1016/j.recesp.2025.10.006","DOIUrl":"10.1016/j.recesp.2025.10.006","url":null,"abstract":"","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":"79 7","pages":"Pages 651-652"},"PeriodicalIF":4.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148544299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cierre percutáneo de comunicaciones interauriculares ostium secundum: predictores ecocardiográficos de embolización del dispositivo","authors":"Grégoire Albenque,&nbsp;Estibaliz Valdeolmillos,&nbsp;Marine Cachanado,&nbsp;Jérôme Petit,&nbsp;Clément Batteux,&nbsp;Sébastien Hascoët","doi":"10.1016/j.recesp.2025.11.004","DOIUrl":"10.1016/j.recesp.2025.11.004","url":null,"abstract":"","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":"79 7","pages":"Pages 640-643"},"PeriodicalIF":4.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148544295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diseño del registro español de intervenciones estructurales y coronarias recomendadas para centenarios: observación e inclusión (REDIRECCION)","authors":"Manuel Martínez-Sellés,&nbsp;J. Ángel Pérez Rivera,&nbsp;Javier Martín Moreiras,&nbsp;Carolina Robles,&nbsp;María Teresa Vidán,&nbsp;Ana Belén Cid Álvarez","doi":"10.1016/j.recesp.2025.11.021","DOIUrl":"10.1016/j.recesp.2025.11.021","url":null,"abstract":"","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":"79 7","pages":"Pages 645-647"},"PeriodicalIF":4.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148544297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Monte Sinaí","authors":"Fernando A. Navarro","doi":"10.1016/j.recesp.2026.01.008","DOIUrl":"10.1016/j.recesp.2026.01.008","url":null,"abstract":"","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":"79 6","pages":"Page 497"},"PeriodicalIF":5.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148190253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anticoagulación oral directa a dosis bajas frente a tratamiento antiagregante plaquetario doble tras el cierre de la orejuela izquierda: resultados a 1 año del ensayo ADALA","authors":"Eduardo Flores-Umanzor ,&nbsp;Ignacio Cruz-González ,&nbsp;Pedro Cepas-Guillén ,&nbsp;Xavi Millán ,&nbsp;Pablo Antúnez-Muiños ,&nbsp;Lluís Asmarats ,&nbsp;Ana Laffond ,&nbsp;Ander Regueiro ,&nbsp;Sergio López-Tejero ,&nbsp;Chi-Hion Pedro Li ,&nbsp;Laura Sanchis ,&nbsp;Josep Rodés-Cabau ,&nbsp;Dabit Arzamendi ,&nbsp;Xavier Freixa","doi":"10.1016/j.recesp.2025.11.015","DOIUrl":"10.1016/j.recesp.2025.11.015","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>The ADALA trial showed a more favorable efficacy-safety profile with low-dose direct oral anticoagulation (LD-DOAC) vs dual antiplatelet therapy (DAPT) at 3 months after left atrial appendage occlusion (LAAO). However, outcomes after switching both regimens to single antiplatelet therapy (SAPT) remain uncertain. This study reports the 1-year results, focusing on outcomes after the switch to SAPT.</div></div><div><h3>Methods</h3><div>The ADALA trial was a multicenter, randomized clinical trial that enrolled 91 patients with atrial fibrillation and contraindications to oral anticoagulation. After successful LAAO, participants were randomized to receive LD-DOAC or DAPT for 3 months, after which all patients transitioned to SAPT. The primary endpoint was a composite of thromboembolic events, device-related thrombus (DRT), or major bleeding at 1-year.</div></div><div><h3>Results</h3><div>At 12 months, the primary endpoint was significantly lower in the LD-DOAC group compared with the DAPT group (9.1% vs 32.6%; HR, 0.25; 95%CI, 0.08-0.74; <em>P</em> <!-->=<!--> <!-->.013), mainly driven by a reduction in DRT (0% vs 11.6%; <em>P</em> <!-->=<!--> <!-->.023). Major bleeding was numerically lower with LD-DOAC (9.1% vs 19.6%; <em>P</em> <!-->=<!--> <!-->.167), and total bleeding events were significantly reduced (13.6% vs 37.0%; <em>P</em> <!-->=<!--> <!-->.013). Landmark analysis showed significant differences during the initial 3 months (<em>P</em> &lt;<!--> <!-->.001) but not from 3 to 12 months (<em>P</em> <!-->=<!--> <!-->.195). All DRT cases treated with LD-DOAC (n<!--> <!-->=<!--> <!-->4) resolved completely without bleeding.</div></div><div><h3>Conclusions</h3><div>LD-DOAC reduced thromboembolic and bleeding events compared with DAPT during the first year after LAAO, driven by a marked reduction in early DRT. No DRT events occurred after LD-DOAC withdrawal, supporting a strategy of LD-DOAC for 3 months followed by SAPT in this high-risk population.</div></div>","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":"79 6","pages":"Pages 522-533"},"PeriodicalIF":5.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148190370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}