Revista espanola de cardiologia最新文献

{"title":"Incidencia, predictores e impacto pronóstico de una clase funcional disminuida inmediatamente después de un implante percutáneo de válvula aórtica","authors":"Jorge Nuche ,&nbsp;Julien Ternacle ,&nbsp;Marisa Avvedimento ,&nbsp;Asim N. Cheema ,&nbsp;Gabriela Veiga-Fernández ,&nbsp;Antonio J. Muñoz-García ,&nbsp;Victoria Vilalta ,&nbsp;Ander Regueiro ,&nbsp;Luis Asmarats ,&nbsp;María del Trigo ,&nbsp;Vicenç Serra ,&nbsp;Guillaume Bonnet ,&nbsp;Melchior Jonveaux ,&nbsp;Giovanni Esposito ,&nbsp;Effat Rezaei ,&nbsp;José M. de la Torre-Hernández ,&nbsp;Eduard Fernández-Nofrerías ,&nbsp;Pablo Vidal ,&nbsp;Lola Gutiérrez-Alonso ,&nbsp;Juan Francisco Oteo ,&nbsp;Josep Rodés-Cabau","doi":"10.1016/j.recesp.2023.11.002","DOIUrl":"10.1016/j.recesp.2023.11.002","url":null,"abstract":"<div><h3>Introduction and objectives</h3><p>There are scarce data on the factors associated with impaired functional status after transcatheter aortic valve replacement (TAVR) and its clinical impact. This study aimed to determine the incidence, predictors, and prognostic implications of impaired functional class (NYHA class III-IV) following TAVR.</p></div><div><h3>Methods</h3><p>This multicenter study included 3462 transarterial TAVR patients receiving newer generation devices. The patients were compared according to their NYHA class at 1 month of follow-up (NYHA I-II vs NYHA III-IV). A multivariate logistic regression was performed to identify the predictors of 30-day NYHA class III-IV. Patient survival was compared with the Kaplan-Meier method and factors associated with decreased survival were identified with Cox regression analysis.</p></div><div><h3>Results</h3><p>The mean age of the study population was 80.3<!--> <!-->±<!--> <!-->7.3 years, with 47% of women, and a median Society of Thoracic Surgeons score of 3.8% [IQR, 2.5-5.8]. A total of 208 patients (6%) were in NYHA class III-IV 1 month after TAVR. Predictors of 30-day NYHA class III-IV were baseline NYHA class III-IV (OR, 1.76; 95%CI, 1.08-2.89; <em>P</em> <!-->=<!--> <!-->.02), chronic pulmonary obstructive disease (OR, 1.80; 95%CI, 1.13-2.83; <em>P</em> <!-->=<!--> <!-->.01), and post-TAVR severe mitral regurgitation (OR, 2.00; 95%CI, 1.21-3.31; <em>P</em> <!-->&lt;<!--> <!-->.01). Patients in NYHA class III-IV 1 month after TAVR were at higher risk of death (HR, 3.68; 95%CI, 2.39-5.70; <em>P</em> <!-->&lt;<!--> <!-->.01) and heart failure-related hospitalization (HR, 6.00; 95%CI, 3.76-9.60; <em>P</em> <!-->&lt;<!--> <!-->.01) at 1-year follow-up.</p></div><div><h3>Conclusions</h3><p>Up to 6% of contemporary TAVR patients exhibited an impaired functional status following TAVR. Worse baseline NYHA class, chronic pulmonary obstructive disease, and severe mitral regurgitation predicted 30-day NYHA class III/IV, and this determined a higher risk of mortality and heart failure hospitalization at 1-year follow-up. Further studies on the prevention and treatment optimization of patients with impaired functional status after TAVR are needed.</p></div>","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":null,"pages":null},"PeriodicalIF":5.9,"publicationDate":"2024-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140278508","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":"Predicción del desarrollo de insuficiencia cardiaca en pacientes con fibrilación auricular","authors":"","doi":"10.1016/j.recesp.2024.02.019","DOIUrl":"10.1016/j.recesp.2024.02.019","url":null,"abstract":"","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":null,"pages":null},"PeriodicalIF":5.9,"publicationDate":"2024-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140268540","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":"Inteligencia artificial y lenguaje médico (III)","authors":"","doi":"10.1016/j.recesp.2023.10.015","DOIUrl":"https://doi.org/10.1016/j.recesp.2023.10.015","url":null,"abstract":"","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":null,"pages":null},"PeriodicalIF":5.9,"publicationDate":"2024-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139986558","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":"Factores asociados a la presencia de xantomas tendinosos en la hipercolesterolemia familiar","authors":"Pablo Corredoira ,&nbsp;Victoria Marco-Benedi ,&nbsp;Ana Cenarro ,&nbsp;Sonia Peribáñez ,&nbsp;Salvador Olmos ,&nbsp;Fernando Civeira","doi":"10.1016/j.recesp.2023.12.010","DOIUrl":"10.1016/j.recesp.2023.12.010","url":null,"abstract":"<div><h3>Introduction and objectives</h3><p>Tendon xanthomas (TX) are lipid deposits highly specific to familial hypercholesterolemia (FH). However, there is significant variability in their presentation among FH patients, primarily due to largely unknown causes. Lipoprotein(a) is a well-established independent risk factor for atherosclerotic cardiovascular disease in the general population as well as in FH. Given the wide variability of lipoprotein(a) among FH individuals and the likelihood that TX may result from a proatherogenic and proinflammatory condition, the objective of this study was to analyze the size of TX in the Achilles tendons of FH participants and the variables associated with their presence, including lipoprotein(a) concentration.</p></div><div><h3>Methods</h3><p>A cross-sectional study was conducted on 377 participants with a molecular diagnosis of heterozygous FH. Achilles tendon maximum thickness (ATMT) was measured using ultrasonography with standardized equipment and procedures. Demographic variables and lipid profiles were collected. A multivariate linear regression model using a log-Gaussian approach was used to predict TX size. Classical cardiovascular risk factors and lipoprotein(a) were included as explanatory variables.</p></div><div><h3>Results</h3><p>The mean low-density lipoprotein cholesterol level was 277<!--> <!-->mg/dL without lipid-lowering treatment, and the median ATMT was 5.50<!--> <!-->mm. We demonstrated that age, sex, low-density lipoprotein cholesterol, and lipoprotein(a) were independently associated with ATMT. However, these 4 variables did not account for most the interindividual variability observed (R² <!-->=<!--> <!-->0.205).</p></div><div><h3>Conclusions</h3><p>TX, a characteristic hallmark of FH, exhibit heterogeneity in their presentation. Interindividual variability can partially be explained by age, male sex, low-density lipoprotein cholesterol, and lipoprotein(a) but these factors account for only 20% of this heterogeneity.</p><p><em>Full English text available from</em>:<span>www.revespcardiol.org/en</span><svg><path></path></svg></p></div>","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":null,"pages":null},"PeriodicalIF":5.9,"publicationDate":"2024-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140468618","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":"Comentarios a la actualización 2023 de la guía ESC 2021 sobre el diagnóstico y tratamiento de la insuficiencia cardiaca aguda y crónica","authors":"Grupo de Trabajo de la SEC para la actualización 2023 de la guía ESC 2021 sobre el diagnóstico y tratamiento de la insuficiencia cardiaca aguda y crónica y Comité de Guías de la SEC","doi":"10.1016/j.recesp.2023.10.021","DOIUrl":"https://doi.org/10.1016/j.recesp.2023.10.021","url":null,"abstract":"","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":null,"pages":null},"PeriodicalIF":5.9,"publicationDate":"2024-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140296363","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":"Amiloidosis por transtirretina diagnosticada en pacientes con una miocardiopatía previa - oportunidades y preguntas abiertas","authors":"Mihnea Casian ,&nbsp;Ruxandra Jurcut","doi":"10.1016/j.recesp.2023.11.016","DOIUrl":"10.1016/j.recesp.2023.11.016","url":null,"abstract":"","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":null,"pages":null},"PeriodicalIF":5.9,"publicationDate":"2024-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140463027","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":"Valor clínico de una herramienta de anticoagulación oral en fibrilación auricular no valvular en atención primaria. Ensayo clínico aleatorizado","authors":"M. Rosa Dalmau Llorca ,&nbsp;Carina Aguilar Martín ,&nbsp;Noèlia Carrasco-Querol ,&nbsp;Zojaina Hernández Rojas ,&nbsp;Dolores Rodríguez Cumplido ,&nbsp;Elisabet Castro Blanco ,&nbsp;Alessandra Queiroga Gonçalves ,&nbsp;José Fernández-Sáez ,&nbsp;Julián Pérez-Villacastín","doi":"10.1016/j.recesp.2023.11.012","DOIUrl":"10.1016/j.recesp.2023.11.012","url":null,"abstract":"<div><h3>Introduction and objectives</h3><p>The management of atrial fibrillation is complex and requires improvement at strategic points, such as in the control of patients treated with vitamin K antagonists. The aim of this study was to evaluate the impact on health outcomes of a nonvalvular atrial fibrillation decision support tool based on visualization of the time in therapeutic range in primary care.</p></div><div><h3>Methods</h3><p>The present randomized clinical trial was conducted in 2018 with a 1-year follow-up in 325 primary care centers in Catalonia. In the intervention centers, the decision support tool was installed to control the time in therapeutic range of patients treated with vitamin K antagonists. The tool was not visualized in the control group.</p></div><div><h3>Results</h3><p>In total, 44 556 patients were studied. The intervention protected against admission for stroke (adjusted odds ratio [OR], 0.70; 95% confidence interval [95%CI], 0.55-0.88). The number needed to treat was 3502 (95%CI, 3305-3725) while the number of admissions for stroke avoided was 12.63 (95%CI, 11.88-13.38). The intervention also protected against mortality (adjusted OR, 0.78; 95%CI, 0.67-0.90), with a number needed to treat of 13 687 (95%CI, 10 789-18 714) and number of deaths avoided of 3.23 (95%CI, 2.36-4.10).</p></div><div><h3>Conclusions</h3><p>The decision support tool was associated with slight reductions in the numbers of admissions for ischemic stroke and mortality. Although the follow-up time was short and the effect of the intervention was small, the results are valuable and could improve implementation of the tool.</p><p>This clinical trial was registered with ClinicalTrials.gov (<span>NCT03367325</span><svg><path></path></svg>).</p><p><em>Full English text available from</em>:<span>www.revespcardiol.org/en</span><svg><path></path></svg></p></div>","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":null,"pages":null},"PeriodicalIF":5.9,"publicationDate":"2024-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0300893223005201/pdfft?md5=5f1b5fe471da3d8adc093b02307efe88&pid=1-s2.0-S0300893223005201-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139966095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Resultados de un programa de cribado poblacional de amiloidosis hereditaria por transtirretina","authors":"Fernando de Frutos ,&nbsp;Isabel Caraballo Ramos ,&nbsp;Victoria Martínez Chaves ,&nbsp;Adoración María Corral Azor ,&nbsp;Mohamed Solimán Berchíd Débdi ,&nbsp;Pablo García-Pavía","doi":"10.1016/j.recesp.2023.12.016","DOIUrl":"10.1016/j.recesp.2023.12.016","url":null,"abstract":"","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":null,"pages":null},"PeriodicalIF":5.9,"publicationDate":"2024-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0300893223005468/pdfft?md5=2de257e422ddf6ae2573e725178d1fdc&pid=1-s2.0-S0300893223005468-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140467072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comentarios a la guía ESC 2023 sobre el diagnóstico y tratamiento de los síndromes coronarios agudos","authors":"Grupo de Trabajo de la SEC para la guía ESC 2023 sobre el diagnóstico y tratamiento de los síndromes coronarios agudos y Comité de Guías de la SEC","doi":"10.1016/j.recesp.2023.11.007","DOIUrl":"10.1016/j.recesp.2023.11.007","url":null,"abstract":"","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":null,"pages":null},"PeriodicalIF":5.9,"publicationDate":"2024-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139821849","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":"Efectividad y seguridad de una estrategia de antiagregación plaquetaria simple tras cierre percutáneo de orejuela izquierda en pacientes con FA","authors":"Marc Llagostera-Martín ,&nbsp;Miguel Cainzos ,&nbsp;Neus Salvatella ,&nbsp;Héctor Cubero-Gallego ,&nbsp;Aleksandra Mas-Stachurska ,&nbsp;Andrea Sánchez-Carpintero ,&nbsp;Helena Tizón-Marcos ,&nbsp;Alicia Calvo-Fernández ,&nbsp;Luis Molina ,&nbsp;Beatriz Vaquerizo","doi":"10.1016/j.recesp.2023.06.005","DOIUrl":"10.1016/j.recesp.2023.06.005","url":null,"abstract":"<div><h3>Introduction and objectives</h3><p>The optimal antithrombotic strategy following left atrial appendage closure (LAAC) is poorly defined in patients with nonvalvular atrial fibrillation. We assessed the safety and effectiveness of a single antiplatelet treatment (SAPT) strategy after LAAC in a population at high risk of ischemic and bleeding events.</p></div><div><h3>Methods</h3><p>This single-center, observational, prospective study included a consecutive cohort of patients who underwent LAAC using the LAmbre device (Lifetech Scientific, China) and who were discharged with SAPT. The primary outcome was a composite of stroke, systemic embolism, and device-related thrombosis during follow-up. Secondary endpoints were cardiovascular mortality and major bleeding events (BARC ≥ 3<!--> <!-->a). Clinical follow-up was performed at 1, 6, and 12 months and subsequently on an annual basis. Transesophageal echocardiography was performed at 1 and 12 months of follow-up.</p></div><div><h3>Results</h3><p>The study comprised 74 patients. The median age was 77 [72-83] years and 43% were women. The cohort exhibited a high prevalence of comorbidities and cardiovascular risk factors. The median CHA₂DS₂-VASc and HAS-BLED scores were 4 [3-6] and 4 [4-5], respectively. The median length of follow-up was 2.5 years (188 patients-year). During follow-up, device-related thrombosis occurred in 3 patients (4%). Ischemic stroke occurred in 1 patient (1.3%, rate 0.5%/y), representing a 90.9% relative risk reduction compared with the risk predicted by CHA₂DS₂-VASc. Major bleeding events occurred in 12 patients (16%, 6.4%/y), with a relative risk reduction of 26.4% of that predicted by HAS-BLED. Cardiovascular-related mortality was observed in 2 patients (2.7%).</p></div><div><h3>Conclusions</h3><p>SAPT appears to be a safe and effective treatment following LAAC in patients at high ischemic and hemorrhagic risk. Further studies are needed to confirm our findings.</p></div>","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":null,"pages":null},"PeriodicalIF":5.9,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"55241704","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}